Uniform Billing Editor (Updateable)

Optum | | Karen Krawzik; Jaqueline Petersen



329.95
List Price

Item #: 4787
ISBN: 9781601519832
Available: NOW








Facilities can use this reference tool daily to manage the constant changes to the Medicare billing and reimbursement process. The Uniform Billing Editor provides detailed, accurate, and timely information about Medicare and UB-04 billing rules and assists the user with 5010 data and UB-04 and 837i requirements.
  • Quickly locate topics based on field locators, revenue codes, or coding structures. This easy-to-use format is fully indexed and tabbed with icons for quick reference.
  • Quickly link HCPCS Level II and CPT® codes to applicable revenue codes. This crosswalk helps you to prevent the most common reasons for rejections — mismatched revenue codes and CPT® or HCPCS Level II codes. 
  • Crosswalk to 837 institutional claims. Provides links to 837i 5010 data elements and any applicable billing rules, facilitating easier transition to the 837i.
  • Coding and billing tips with quick access to official sources. Submit claims to Medicare accurately the first time, helping you reduce claim delays and denials.
  • Includes 5010 standards and provides detailed, accurate, and timely information about Medicare billing and reimbursement.
  • OCE and MCE edits. Identify data inconsistencies, potential rejections, and denials through OCE and MCE edits.
  • Timely updates throughout the year. Stay current with changes to help you eliminate billing with outdated information.


CPT is a registered trademark of the American Medical Association.

Karen Krawzik, RHIT, CCS, AHIMA-approved ICD-10-CM/PCS Trainer

Ms. Krawzik has expertise in ICD-10-CM, ICD-9-CM, CPT®/HCPCS, DRG and data quality and analytics, with more than 30 years’ experience coding in multiple settings, including inpatient, observation, ambulatory surgery, ancillary and emergency room. She has served as a DRG analyst and auditor of commercial and government payer claims, as a contract administrator, and worked on a team providing enterprise-wide conversion of the ICD-9-CM code set to ICD-10. More recently, she has been developing print and electronic content related to ICD-10-CM and ICD-10-PCS coding systems, MS-DRGs and HCCs. Ms. Krawzik is credentialed by the American Health Information Management Association (AHIMA) as a Registered Health Information Technician (RHIT) and a Certified Coding Specialist (CCS) and is an AHIMA-approved ICD-10-CM/PCS trainer. She is an active member of AHIMA and the Missouri Health Information Management Association.

CPT is a registered trademark of the American Medical Association.

Jaqueline Petersen, RHIA, CHDA, CPC

Ms. Petersen is a subject matter expert (SME) with Optum360. She has served as Senior Clinical Product Research Analyst with Optum360 developing business requirements for edits to support correct coding and reimbursement for claims processing applications. Her experience includes development of data-driven and system rules for both professional and facility claims and in-depth analysis of claims data inclusive of ICD-10-CM, CPT®, HCPCS and modifiers. Her background also includes consulting work for Optum, serving as a SME, and providing coding and reimbursement education to internal and external clients. Ms. Petersen is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).

CPT is a registered trademark of the American Medical Association.


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