Insurance claim transmitted to an insurance carrier that cannot be processed due to missing, certain incomplete, or incorrect information.
Tag: MEDICAL
Unproved procedures
See: experimental procedures .
Unreplaced blood
In the Medicare program, a beneficiary who receives blood may either restore the blood or pay the provider’s charges for the unrestored blood. Blood is replaced on a pint-for-pint or unit-for-unit basis.
Unreported claims
See: incurred but not reported (IBNR) .
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A reserve kept to pay claims that have taken place but have not yet been reported. The amount of this reserve is based on estimates.
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UK: See: IBNR FOR CLAIMS INCURRED BUT NOT YET REPORTED.
Unrepresented employee
In a workers’ compensation case, injured worker who is not represented by an attorney.
Unsecured debt
Obligation (amount owed) that is not secured or backed by any form of collateral.
Unspecified
See: not otherwise specified (NOS) and nonspecific code .
Unusual procedural service
Procedure or service that is unique or an atypical finding that affects the patient’s treatment. When billing for an unusual procedural service, a -22 modifier is appended to the usual five-digit CPT procedure code when the service provided is greater than that usually required for the listed procedure.
UP
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating three patients served.
Upcode
See: upcoding .