UB04 Admission Hour Code 11: 11:00 AM - 11:59 AM

Overview

Admission Hour Code 11 on the UB-04 claim form represents the hour of admission between 11:00 AM and 11:59 AM. This code is part of the admission hour field (FL 13) and must be entered in military time (00–23), where 00 = 12:00 AM (midnight), 01 = 1:00 AM, and so on up to 23 = 11:00 PM ^[1]. The UB-04 claim form is used for institutional billing. The MassHealth UB-04 Billing Guide confirms that the UB-04 form includes code sets for fields such as admission hour, though it does not specify individual hour codes ^[2]. Accurate reporting of the admission hour is essential for proper claim processing, utilization review, and reimbursement calculations.

When to Use

Use Admission Hour Code 11 when the patient’s admission to inpatient care or the start of outpatient care occurs at any time between 11:00 AM and 11:59 AM. The hour is reported in military time, so 11:00 AM is coded as 11, and 11:59 AM is also coded as 11 because the code represents the entire hour block ^[1]. This code applies to all inpatient admissions (e.g., acute care, psychiatric, rehabilitation) and to outpatient services that require a start-of-care date/hour (e.g., observation, outpatient surgery). The admission hour must be consistent with the admission date reported in FL 13. For example, if a patient is admitted on March 15 at 11:30 AM, the date is 03/15/YYYY and the hour code is 11. Do not use code 11 for admissions that occur at 10:59 AM (use code 10) or 12:00 PM (use code 12). The MassHealth guide emphasizes that all UB-04 fields must be completed accurately to avoid claim rejections [MassHealth UB-

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