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Direct Data Entry (DDE) User’s Guide - Palmetto GBA

A CMS Medicare Administrative Contractor Direct Data Entry (DDE). User's Guide Section 4: Claims & Attachments Main Menu Option 02. CPT only copyright 2012 American Medical Association. All Rights Reserved. March 2019. Section 4: Claims & Attachments DDE User's Guide TABLE OF CONTENTS. TABLE OF CONTENTS I. TABLE OF FIGURES I. ACRONYMS I. Direct DATA Entry (DDE) USER'S Guide BREAKDOWN III. SECTION 4 CLAIMS & ATTACHMENTS 1. General Information .. 1. Transmitting Data .. 1. Electronic UB-04 Claim Entry .. 2. UB-04 Claim Entry Page 2. UB-04 Claim Entry Page 6. UB-04 Claim Entry Page 2: Additional NPI Lines .. 9. UB-04 Claim Entry Page 2: Line Level Reimbursement .. 10. UB-04 Claim Entry Page 2: Additional Detail .. 17. UB-04 Claim Entry Page 24. UB-04 Claim Entry Page 3: MSP Payment Information .. 29. UB-04 Claim Entry Page 3: Provider Practice Location Address .. 31. UB-04 Claim Entry Page 32. UB-04 Claim Entry Page 33. UB-04 Claim Entry Page 35.

health payment totals. 4 Claims & Attachments (Main Menu Option 02) This section includes instructions, screen illustrations, and field descriptions on how to enter UB-04 claim information, including home health requests for anticipated payment (RAPs), hospice notice of elections (NOEs), and roster bill data entry. 5 Claims Correction (Main Menu

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