What is a Late Bill Override Date?

A term you will hear from time to time, especially if your practice is still filing your own claims and you haven’t outsourced your medical billing yet, is LBOD.

LBOD stands for Late Bill Override Date and it’s fairly cut and dried. Basically the provider uses the LBOD to document compliance with timely filing requirements which insures that you get reimbursed for services rendered. Generally, you should only use the LBOD if you are filing a claim with dates of service older than 120 days and you must have all documentation on file for these addendums to your medical billing claims.

The LBOD is permissible to use on either paper or electronic medical billing claims. It is also a good idea to keep a copy of the WINASAP rejection of your medical billing claim if you are using that as your LBOD date, however, your refiling must come within the original Medical Assistance Program timely filing period. Generally speaking, the LBOD cannot be greater than 60 days from the last date of adverse action (denial or return of the medical billing).

The coding to use to file the LBOD on the standard form is at CO-1500 and simply enter the LBOD on the line item data page. UB92 forms are handled a little differently, enter the LBOD on the Claim Data page in the LB Override Date field and enter the Occurrence Code 53.

This reason code replaces the LBOD on HIPAA compliant 837 transactions.
Knowing this updated coding will help prevent your LBOD claim from being rejected.

There are 7 DRCs (Delay Reason Codes) used instead of a LBOD when resubmitting medical billing claims. In notes section of the claim header simply write a general description of the numeric value used for this purpose:
DRCs:
1 Proof of Eligibility Unknown or Unavailable
3 Authorization Delays
7 Third Party Processing Delay
8 Delay in Eligibility Determination
9 Original Claim Rejected or Denied Due to a Reason Unrelated to the Billing Limitation Rules
11 Other

Remember, good documentation is the key when filing out a LBOD form, make sure you have all your documentation in the file and notes in detail before refiling to insure your claim gets handled and reimbursed.

View all Articles by: Melissa C. - OMG, LLC. CEO