Overview
The UB-04 claim form utilizes Form Locator 13 to identify the specific hour a patient was admitted for medical services. Code 19 specifically represents the one-hour window between 07:00 PM and 07:59 PM [1]. This code is part of a standardized 24-hour clock system used by healthcare facilities to document the start of care for both inpatient and outpatient encounters [1]. By entering "19" in this field, the provider signifies that the patient's formal admission process occurred during the evening hours, specifically the seventh hour after noon [1].
Accurate time reporting via Code 19 is essential for tracking hospital utilization and ensuring that the clinical timeline matches the medical record documentation. While the system uses a two-digit format ranging from 00 to 23, Code 19 is the designated value for the 7:00 PM hour [1]. This data point allows payers to verify the necessity of services rendered at specific times and helps establish the "room and board" charges or observation hours that may follow the admission event [1].
When to Use
Code 19 must be used in Form Locator 13 whenever a patient is admitted for inpatient care between 07:00 PM and 07:59 PM [1]. This requirement applies to nearly all inpatient claims, with the specific exception of bill type 21x, which is reserved for intermediate care facilities [1]. For most other hospital settings, providing the admission hour is a mandatory component of the billing process to ensure the claim is considered complete for processing [1].
In addition to inpatient requirements, Code 19 may be used for outpatient billing, though it is considered optional in those scenarios [1]. When a patient arrives at an outpatient department or is placed in observation during the 7:00 PM hour, the provider has the discretion to include Code 19 to provide a more detailed clinical picture [1]. However, for standard inpatient stays (excluding 21x), the code is a required data element that must reflect the actual time the patient was admitted for care according to the facility's records [1].
Step-by-Step Claim Example
To correctly report an admission occurring at 07:30 PM, the billing specialist must follow a specific sequence on the UB-04 form. First, the specialist identifies the exact time of admission from the medical record, which in this case falls within the 07:00 PM to 07:59 PM window [1]. Next, the specialist references the standardized code table to find the corresponding value for the 7:00 PM hour, which is Code 19 [1].
The specialist then locates Form Locator 13 on the UB-04 claim form. In this field, the two-digit code "19" is entered to represent the admission hour [1]. Following this, the specialist must also address Form Locator 14, which indicates the Priority (Type) of Visit [1]. For example, if the patient admitted at 07:30 PM required immediate medical intervention for a life-threatening condition, the specialist would enter Code 1 (Emergency) in FL 14 [1]. This combination of Code 19 in FL 13 and the appropriate priority code in FL 14 ensures the claim accurately reflects both the timing and the urgency of the patient's admission [1].
Common Mistakes & Audit Red Flags
One common mistake is the confusion between the 12-hour and 24-hour clock formats. Providers may mistakenly use Code 07 (which represents 07:00 AM to 07:59 AM) when they intend to report an evening admission at 7:00 PM [1]. This error creates a discrepancy in the medical record, as the billing time will not align with the clinical notes, potentially leading to claim denials or audit flags [1]. Auditors look for consistency between the admission hour in FL 13 and the nursing or physician documentation regarding when the patient actually arrived and was processed [1].
Another frequent error involves the misapplication of the code to exempt bill types. While Code 19 is required for most inpatient claims, it should not be used for bill type 21x (intermediate care facilities) [1]. Including an admission hour on these specific claims may be unnecessary and could lead to processing delays [1]. Additionally, failing to provide an admission hour on required inpatient claims is a significant red flag that can result in the claim being returned as incomplete [1]. Providers must ensure that Code 19 is only used when the admission time truly falls within the 19:00 to 19:59 timeframe [1].
Related Codes/Fields
| Field / Code | Description | Requirement |
|---|---|---|
| FL 13 / Code 07 | 07:00 AM - 07:59 AM | Used for morning admissions [1] |
| FL 13 / Code 18 | 06:00 PM - 06:59 PM | Used for admissions in the hour preceding Code 19 [1] |
| FL 13 / Code 20 | 08:00 PM - 08:59 PM | Used for admissions in the hour following Code 19 [1] |
| FL 14 / Code 1 | Emergency Priority | Indicates immediate intervention is required for life-threatening conditions [Maryland Medicaid — FL 13 (Code 19)] |
| Bill Type 21x | Intermediate Care | Specifically exempt from the admission hour reporting requirement [Maryland Medicaid — FL 13 (Code 19)] |
References
[1] Maryland Medicaid — FL 13 (Code 19) — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf
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Start ExtractingThis guide was developed using official CMS and NUBC guidelines, combined with patterns observed from processing thousands of real UB-04 documents through our system.
Last Updated: 2026-05-29
Sources: CMS Pub. 100-04 Chapter 25, NUBC Official UB-04 Manual, Medicare Contractor Bulletins (Noridian, Palmetto, CGS)