U
UB04 Claim form for hospitals, clinics, or any provider billing for facility fees similar to CMS 1500.
Unbundling Submitting several CPT treatment codes when only one code is necessary.
Untimely Submission Medical claim submitted after the time frame allowed by the insurance payer.
Upcoding An illegal practice of assigning an ICD diagnosis code that does not agree with the patient records for the purpose of increasing reimbursement.
UPIN Unique Physician Identification Number. 6 digit physician identification number created by CMS. Discontinued in 2007 and replaced by NPI number.
Usual Customary & Reasonable (UCR) The allowable coverage limits (fee schedule) determined by the patient’s insurance company.
Utilization Limit The limits that Medicare sets on how many times certain services can be provided within a year.
Utilization Review (UR) Review or audit conducted to reduce unnecessary inpatient or outpatient medical services or procedures.
V
V-Codes ICD-9-CM coding classification to identify health care for reasons other than injury or illness.
W
Workers Comp Insurance claim that results from a work related injury or illness.
Write-off The difference between what the physician charges and what the insurance plan contractually allows that the patient is not responsible for.