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 Click to download Sample UB-92 Claim Form.
It is important to confirm all codes with third-party payers as requirements may differ. Codes provided in this resource serve only as a guide and their use does not guarantee payment. Each provider is responsible for ensuring that billing and coding for all products and services is correct.
The information provided in this section of Ikaria's website is for educational purposes only and is not intended to serve as reimbursement or legal advice. The information on each document is based on the stated assumptions contained in the respective document and is current as of the date of the document. Reimbursement information is subject to change at any time, so you should check with your specific payers to ensure that you have the most up-to-date information applicable to them. Ikaria® endeavors to remove any outdated information from this site, but cannot assure you that payers have not modified their decisions and approach. It is each provider's responsibility to determine whether the services actually provided are accurately described by any specific code(s) and to report those services consistent with specific payer requirements. Ikaria® recommends that you consult with your reimbursement advisor, legal counsel and/or payer representatives with any questions regarding appropriate coding and reporting of INOmax and INOtherapy®. In all cases, services billed must be medically necessary, actually performed as reported and appropriately documented.
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For complete INOmax prescribing information, CLICK HERE
Information intended for the United States. For information outside the US CLICK HERE
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