FLs 8-17 on the UB-04 contain various types of patient information. One type is the patient's identifying information, including the full name, address, date of birth, and sex. Patient admission information and patient discharge information are also reported in these form locators.
There are important formatting requirements for reporting the patient's identifying information (FL 8b). For example, the name is reported in the order of last name, first name, and middle initial, with a comma or space separating each part. For Medicare patients, the name must be exactly as shown on the Medicare health insurance card. A full and correct mailing address must be provided, including a valid ZIP code. The patient's date of birth must contain eight characters reported in the MMDDYYYY format.
The patient's admission information includes the date and hour of admission, as well as the type and point of origin for admission. This information is used by payers to determine patients' benefits. Type of admission data is also used for QIO review. The Admission, Start of Care Date field (FL 12) contains the date the patient was admitted for
inpatient care or the start of care date for home health services. The Admission Hour field (FL 13) contains the hour during which the patient was admitted for inpatient care.
The Type of Admission or Visit field (FL 14) contains one of several single-digit codes that establish the level of urgency of an inpatient admission: emergency, urgent, elective, or newborn.
The Point of Origin for Admission or Visit field (FL 15) contains two sets of single-digit codes for reporting the point of origin for the admission or outpatient registration represented by the claim. The point of origin can be a non-health care facility such as home, work, or a physician's office; a transfer from a health care facility or emergency department; an order from a court of law or a law enforcement agency representative; or in the case of a newborn, birth inside the billing hospital or elsewhere. The first set of codes applies to all admission types except newborn admissions. The second set classifies newborn admissions.
The patient's discharge information includes the Discharge Hour field (FL 16) and the Patient Discharge Status field (FL 17). Patient discharge status is an indicator of the patient's disposition at the end of the billing period represented on the claim. There are numerous two-digit patient status codes that fall into one of four categories: routine discharge, discharged to another facility, still a patient, or expired. Payers require this information to determine whether to expect additional bills and from whom to
expect them.
