UB04 Field 10: Patient Birthdate

Overview

Field 10 (Patient Birthdate) is a required data element on the UB-04 claim form for both inpatient and outpatient services. This field captures the patient's date of birth in the format MMDDCCYY (month, day, and four-digit year). The requirement is consistent across all payer types, including Medicare and Medicaid. ^[1] explicitly states that the provider must enter the month, day, and year of birth. If the full birth date is unknown, the provider should indicate zeros for all eight digits. ^[2] similarly requires the month, day, and year of birth (MMDDYYYY). The birth date must match the patient's name as entered in Field 8b, which should appear as it does on the Medical Assistance card. For newborns, the provider must use the newborn's full name and corresponding birth date. ^[3] confirms that Field 10 is required without exception.

When to Use

Field 10 must be completed on every UB-04 claim, regardless of the type of service or patient status. It is required for inpatient admissions, outpatient services, and start of care dates. ^[2] specifies that the birth date is required for all claims, including those for chronic, psychiatric, and rehabilitation hospitals, as well as Residential Treatment Centers (RTC) and nursing facilities. The field is used to verify patient identity and to ensure accurate matching with other records, such as the patient's name in Field 8b. ^[1] notes that the birth date is recorded at admission, outpatient service, or start of care. For newborns, the birth date must reflect the actual date of birth, not the date of admission. If the patient's full birth date is unknown, the provider must enter zeros for all eight digits, though this should be rare in practice. The field is essential for age-related billing considerations, such as determining Medicare eligibility or applying age-specific diagnosis codes.

Step-by-Step Claim Example

Scenario: A 45-year-old female patient, Jane Doe, is admitted for inpatient surgery on January 15, 2024. Her date of birth is March 22, 1978.

Step 1: Locate Field 10 on the UB-04 form. It is typically found in the patient demographic section, near Fields 8b (Patient Name) and 11 (Patient Sex).

Step 2: Enter the birth date in the required format. For Medicare and most payers, use MMDDCCYY (eight digits). For Maryland Medicaid, use MMDDYYYY (eight digits). In this example, enter "03221978" for March 22, 1978.

Step 3: Verify the birth date matches the patient's name in Field 8b. For Jane Doe, ensure the name is entered as "Doe, Jane" (last name, first name, middle initial) as it appears on the Medical Assistance card. ^[2] requires the patient's name to match the Medical Assistance card.

Step 4: If the patient is a newborn, use the newborn's full name and actual birth date. For example, if a baby is born on January 16, 2024, enter "01162024" in Field 10 and the baby's full name in Field 8b.

Step 5: If the birth date is unknown (rare), enter "00000000" for all eight digits. ^[1] allows this only when the full birth date is unknown.

Step 6: Double-check the format. Do not use slashes, dashes, or spaces. The entry must be exactly eight digits. For example, "03221978" is correct; "03/22/1978" is incorrect.

Step 7: Ensure the birth date is consistent with other fields, such as Field 12 (Admission/Start of Care Date) and Field 6 (Statement Covers Period). The birth date should logically precede the admission date.

Common Mistakes & Audit Red Flags

1. Incorrect Format: Entering the date with slashes, dashes, or spaces (e.g., "03/22/1978" instead of "03221978"). This can cause claim rejection or processing delays. ^[1] requires MMDDCCYY format.

2. Mismatched Name and Birth Date: Entering a birth date that does not match the patient's name in Field 8b. For example, using a newborn's birth date but the mother's name. ^[2] requires the patient's name as it appears on the Medical Assistance card.

3. Using Two-Digit Year: Entering "032278" instead of "03221978" for a 1978 birth date. Medicare and most payers require four-digit years. ^[1] specifies MMDDCCYY.

4. Zeros for Known Birth Date: Entering "00000000" when the birth date is actually known. This is only acceptable when the full birth date is truly unknown. ^[1] allows zeros only in that specific circumstance.

5. Newborn Birth Date Errors: Using the date of admission instead of the actual birth date for newborns. The birth date must reflect the baby's actual date of birth, not the date the mother was admitted.

6. Audit Red Flag — Age Discrepancies: If the birth date in Field 10 does not match the patient's age as implied by other fields (e.g., diagnosis codes for age-specific conditions), it may trigger an audit. For example, a birth date indicating a 5-year-old patient with a diagnosis of age-related macular degeneration would be suspicious.

7. Inconsistent with Other Payers: If the same patient has claims with different payers, the birth date must be consistent across all claims. Discrepancies can lead to claim denials or fraud investigations.

Related Codes/Fields

Field/Code	Description	Relationship to Field 10
FL 8b — Patient Name	Patient's full name as on Medical Assistance card	Must match the birth date for identity verification
FL 11 — Patient Sex	Patient's sex (M, F, or U)	Used with birth date for demographic matching
FL 12 — Admission/Start of Care Date	Date of admission or start of care	Birth date must logically precede this date
FL 6 — Statement Covers Period	From and Through dates for the claim	Birth date must be before the "From" date
FL 74 — Principle Procedure Date	Date of principal procedure	Must fall within the statement covers period
Type of Bill Frequency Code	Indicates claim type (e.g., 3 or 4 for adjustment)	Affects date validation rules for other fields
Patient ID (FL 8a)	Patient's identifier if different from subscriber	Used with birth date for patient matching

Sources:

• ^[2]
• ^[1]
• ^[3]

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References

[1] CMS R1929CP — https://www.cms.gov/transmittals/downloads/R1929CP.pdf

[2] Maryland Medicaid — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf

[3] CMS R1915CP — https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1915CP.pdf