EDIT |
EDIT DESCRIPTION |
UB-04 CLAIM FIELD LOCATION AND DESCRIPTION |
Missing Account ID - Inpatient |
The account ID is missing from the claim. |
Field 3b - medical/health record number |
Invalid Condition Code |
The condition code <1> on the claim is invalid. |
Fields 18-28 - condition codes |
Patient DOB is Missing - Inpatient |
Patient's date of birth is missing on the claim. |
Field 10 - birthdate |
Patient DOB is Invalid - Inpatient |
Patient's date of birth <1>is invalid on the claim. |
Field 10 - birthdate |
Missing or Invalid Statement Covers Period From/Through Date - Inpatient |
Missing admission date or invalid statement covers period from or through dates. |
Field 6 - statement covers period: from-through |
Inpatient Facility Discharge Date Missing |
The discharge date is missing. |
Field 6 - statement covers period: from-through |
Inpatient Principal Procedure Required |
A principal procedure code is required when a procedure code is found in the other procedure code field. |
Field 74 - principle procedure: code and date |
Facility Medicare ICD-10 Code Rule |
Per CMS guidelines, ICD-10 codes can’t be billed for dates of service prior to October 1, 2015. |
Fields 67: principal diagnosis code Field 67a through 6yq: other diagnosis codes |
Facility Medicare ICD-9 Code Rule |
ICD-9 code types can’t be billed for dates of service greater than September 30, 2015. |
Fields 67: principal diagnosis code Field 67a through 6yq: other diagnosis codes |
Invalid Occurrence Code |
The occurrence code <1> on the claim is invalid. |
Fields 31-34: code and date |
Invalid Occurrence Span Code |
The occurrence span code <1> on the claim is invalid. |
Fields 35-36: occurrence span: code and from/through dates |
Missing Patient ID - Inpatient |
No patient ID was submitted on the claim. |
Field 8a: patient Id |
Interim Claims with Frequency Code 2 and 3 Requires Patient Discharge Status Code 30 - Inpatient |
Per Medicare guidelines, the patient discharge status code must be 30 [still patient] when the frequency digit is the type of bill 2 [Interim- First Claim] or the frequency digit is the type of bill 3 [Interim- Continuing Claim]. |
Field 4: type of bill Field 17: discharge status |
Missing Provider ID - Inpatient |
The provider ID is missing from the claim. |
Field 76:attending Field 77: operating Fields 78-79: other |
Point of Origin for Admission is Required on all Institutional Claims with the Exception of 014X |
Point of origin for admission is missing or invalid. |
Field 15: point of origin for admission/visit |
Missing Type of Admission |
This claim has a missing type of admission code. |
Field 14: priority/type of admission |
Invalid Type of Admission |
This claim has an invalid type of admission code <1>. |
Field 14: priority/type of admission |
Type of Admission Frequency |
Type of admission code 4 (newborn), can’t be billed more than once in a lifetime. |
Field 14: priority/type of admission |
Invalid Type of Bill - Inpatient |
The type of bill code is invalid or missing. |
Field 4: type of bill |
Missing or Invalid Type of Bill - Inpatient |
The type of bill code is invalid. |
Field 4: type of bill |
Invalid Value Code |
This claim has an invalid value code <1>. |
Fields 39-41: value codes and amounts |