.
.

Box 16 on ub04 instructions >> DOWNLOAD

Box 16 on ub04 instructions >> READ ONLINE

.
.
.
.
.
.
.
.
.
.

ub04 value codes

patient relationship codes on ub04

ub04 condition codesub-04 billing instructions

ub-04 admission source codes list

ub-04 manual 2019

ub-04 form instructions cms

ub04 poa box

75 – General Instructions for Completion of Form CMS-1450 for Billing. 75.1 – Form Locators 1-15. 75.2 – Form Locators 16-30. 75.3 – Form Locators 31- This form, also known as the UB-04, is a uniform institutional provider bill suitable for use in billing and name, post office box number or RFD, city, State, and ZIP Code.

Field type Instructions 16 Discharge Hour Conditional Required for some accounts including all Medicaid claims. This field is used for reporting the hour the patient is discharged from inpatient care.
Dec 4, 2018 –

NOTE: An asterisk (*) beside field numbers indicates required fields on all outpatient an electronic version of the UB-04 claim form for outpatient services are 15. Source of Admission (SRC). Leave blank. 16. Discharge Hour. Leave blank.
filling in each field on the UB-04 claim form is required, not required, required 16. Discharge hour. Enter the hour of discharge from inpatient care in military
box does not show up on the Alpha MCS UB-04 claim form. Box 16 – Discharge Hour(DHR): (Required if applicable)This field requires two digit(military.
NOTE: Claims with missing or invalid Required (R) field information will be rejected specified by the NUBC UB-04 Uniform Billing Manual 16- 04:00 to 04:59.PR0041 V1.5 01/25/18. UB-04 CLAIM FORM INSTRUCTIONS. FIELD. NUMBER 16. Discharge Hour. Enter the hour (using a two-digit code below) that.
NOTE: Claims with missing or invalid Required (R) field information will be rejected specified by the NUBC UB-04 Uniform Billing Manual 16- 04:00 to 04:59.PR0041 V1.5 01/25/18. UB-04 CLAIM FORM INSTRUCTIONS. FIELD. NUMBER 16. Discharge Hour. Enter the hour (using a two-digit code below) that.
UB-04 data field requirements. Field location. UB-04. Description. Inpatient 16. Discharge Hour. Required. N/A. 17. Patient Discharge Status. Required.