UB04 Admission Hour Code 17: 05:00 PM - 05:59 PM

Overview

The UB-04 admission hour code 17 represents the one-hour window from 05:00 PM to 05:59 PM when a patient is admitted for inpatient care or begins outpatient care. This code is required on inpatient bills only and is entered in Form Locator (FL) 13 – Admission/Start of Care Date. According to the CMS transmittal, the admission hour must be reported using military time, with code 00 for 12:00 AM (midnight), 01 for 1:00 AM, and so on through 23 for 11:00 PM ^[1]. Code 17 corresponds to 17:00 military time, which is 5:00 PM.

When to Use

Payers like MassHealth expect the hour to reflect the exact time the patient was placed in a bed or received the first treatment related to the admission ^[2]. For example, if a patient is admitted to the hospital at 5:30 PM for pneumonia, the admission hour code should be 17. Using the wrong hour may lead to claim rejections, especially when the hour is used for length-of-stay calculations (e.g., Medicare’s midnight rule). Always verify the admission time from the physician’s order or nursing record to ensure accuracy.

Step-by-Step Claim Example

Consider a patient admitted on January 15, 2025, at 5:47 PM for an acute myocardial infarction. Follow these steps to complete the UB-04:

• FL 13 (Admission/Start of Care Date): Enter the date as 01/15/2025.
• FL 13 (Admission Hour): Enter the two-digit military hour code 17 immediately after the date (or in the hour field as specified by the payer). The entire FL 13 entry could appear as 01/15/2025 17 ^[1].
• FL 14 (Priority of Admission/Type of Visit): Select the appropriate code (e.g., 1 for emergency).
• FL 15 (Point of Origin for Admission or Visit): Code 4 for emergency department transfer.
• FL 17 (Patient Status): Code 01 if discharged home.

The MassHealth Billing Guide reminds providers to use the standard code sets; the hour must be filled in even when the exact minute is not required ^[2]. The completed FL 13 signals to the payer that the patient was admitted during the 5:00 PM hour, which may affect observation vs. inpatient status and payment calculations.

Common Mistakes & Audit Red Flags

A frequent error is using code 17 when the actual admission time is 4:50 PM or 6:01 PM. The hour code is based on the clock hour (00–23), not the minute. For example, an admission at 4:55 PM should be code 16 (04:00 PM–04:59 PM), not 17 ^[1]. Another mistake is omitting the hour altogether on inpatient claims; payers may deny the claim as incomplete. Auditors often flag inconsistent hour codes, such as code 17 with a discharge date that suggests an unreasonably short or long stay (e.g., discharge the same day without observation). When the admission hour is missing or conflicts with other fields like FL 14 (emergency) or FL 15 (point of origin), it triggers a review. The MassHealth guide stresses that all required fields must be accurate to avoid delays in payment ^[2]. Providers should double‑check nursing notes and admission logs to ensure the hour matches the documented time.

Related Codes/Fields

The following table lists fields and codes that interact with admission hour code 17:

Field / Code	Description	Relevance to Admission Hour 17
FL 13	Admission/Start of Care Date and Hour	Contains the date and hour code (e.g., 17)
FL 14	Priority of Admission / Type of Visit	Emergency (1) or elective (2) may affect admission hour rules
FL 15	Point of Origin for Admission / Visit	Code 4 (ED) often used with hour 17 for evening admissions
FL 16	Patient Discharge Status	Discharge hour (FL 16) should be later than admission hour
Code 00	12:00 AM – 12:59 AM	Opposite end of day; used for midnight admissions
Code 23	11:00 PM – 11:59 PM	Last hour of day; near code 17 but later

All codes and fields are defined in the CMS transmittal for FL 13 ^[1] and the MassHealth billing guide for general UB-04 completion ^[2].

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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