UB04 Admission Hour Code 07: 07:00 AM - 07:59 AM

Overview

The admission hour code 07 on the UB‑04 claim form represents the one‑hour interval 07:00 AM – 07:59 AM in military time. This code is entered in Field 13 (Admission/Start of Care Date) on inpatient bills only. ^[1] specifies that “the admission hour code (00–23) represents the hour of admission in military time,” with 00 = 12:00 AM (midnight), 01 = 1:00 AM, and so on through 23 = 11:00 PM. Code 07 therefore corresponds to the seventh hour after midnight, i.e., from 07:00 to 07:59 AM. The hospital must report the exact hour (not minutes) during which the patient was physically admitted to inpatient status. The MassHealth UB‑04 Billing Guide (BG‑UB‑04) confirms that the UB‑04 claim form uses standard code sets for all data elements, including the admission hour. ^[2]

When to Use

Use code 07 when the patient’s inpatient admission began between 07:00 AM and 07:59 AM (inclusive of 07:00 but before 08:00). According to ^[1], Field 13 is “required on inpatient bills only” and “the admission hour code (00–23) represents the hour of admission in military time.” Therefore, code 07 applies exclusively to inpatient stays (not outpatient encounters). If the admission occurred at exactly 07:00 or any minute through 07:59, the correct code is 07. Do not round to the nearest hour; use the actual hour of admission. The MassHealth UB‑04 Guide notes that all paper claim submissions must follow the standard code sets (including the hour field) to ensure correct processing. ^[2]

Step‑by‑Step Claim Example

Assume a patient is admitted to inpatient status on March 15, 2025, at 07:30 AM. On the UB‑04 claim form, complete Field 13 as follows:

1. Date: Enter the admission date in the MM‑DD‑YY or MMDDYY format as specified by the payer. For this example: 03‑15‑25.
2. Hour: Enter the military‑time hour code 07 (representing 07:00–07:59 AM).

The completed field should appear as 03‑15‑25 07 (or 03152507 if formatted without separators). ^[1] states that “the admission hour code (00–23) represents the hour of admission in military time,” and code 07 is the correct choice for 07:30 AM. The MassHealth UB‑04 Guide reiterates that the claim form must be completed “in accordance with the instructions and code sets” provided in the billing guide. ^[2] If the claim is submitted electronically (as required by MassHealth for most providers), the same date and hour values are transmitted in the corresponding electronic data elements.

Common Mistakes & Audit Red Flags

• Using 12‑hour format or text: Never enter “7 AM” or “07:00”; only the numeric code 07 is accepted. ^[1] explicitly defines “admission hour code (00–23)” in military time.
• Rounding to a different hour: If admission was at 07:40 AM, code 07 is still correct. Do not round to 08. The code reflects the hour the admission actually started, not the nearest hour.
• Omitting the hour entirely: Field 13 requires both a date and an hour code. Missing the hour can cause claim rejection. ^[1] states this field is “required on inpatient bills only.”
• Mistaking midnight codes: Code 07 is not for 7:00 PM (which would be 19). Verify the time of day.
• Using code 07 on outpatient claims: The CMS transmittal restricts Field 13 to inpatient bills. Applying code 07 to an outpatient claim may prompt an audit or denial. ^[1]
• Inconsistent documentation: The medical record must show an admission time between 07:00 and 07:59 to support code 07. Auditors often compare the claim hour to the physician’s admission order and nursing notes. ^[2] (The guide emphasizes correct claim completion to avoid delays.)

Related Codes/Fields

Field / Code	Description	Source
Field 13	Admission/Start of Care Date (required on inpatient bills only)	[1]
Code 00	12:00 AM – 12:59 AM (midnight hour)	[1]
Code 07	07:00 AM – 07:59 AM	[1]
Code 23	11:00 PM – 11:59 PM	[1]
Field 14	Priority (Type) of Admission or Visit	[2]
Field 15	Source of Admission	[2]

All admission hour codes (00–23) are defined by ^[1]. Field 13 itself and related Fields 14 and 15 are listed in the ^[2] as standard UB‑04 elements.

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References

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

[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download