UB04 Type of Bill Code 0111: Hospital Inpatient (Including Medicare Part A) - Admit through Discharge Claim

Overview

Type of Bill (TOB) code 0111 is a four-digit alphanumeric code used on the UB‑04 claim form to identify a hospital inpatient claim that includes Medicare Part A services and covers the entire episode from admission through discharge. The code is structured as follows: a leading zero (ignored by CMS), a second digit “1” indicating the facility type is Hospital, a third digit “1” indicating the type of care is Inpatient Part A (except clinics), and a fourth digit “1” indicating the frequency is Admit Through Discharge ^[1]. This combination signals that the provider is submitting a single, complete claim for an inpatient stay that began with admission and ended with discharge, with no interim or late‑charge claims involved. Code 0111 is the most common Type of Bill for routine inpatient stays and is essential for accurate claim submission and proper reimbursement under Medicare Part A and other insurance programs.

When to Use

Use Type of Bill code 0111 when a patient is admitted to a hospital as an inpatient, receives care covered under Medicare Part A (or equivalent inpatient benefits), and is discharged after the stay is complete. The claim must represent the entire period from admission to discharge, with no interim billing or late charges. This code is appropriate for a single, final claim that covers all services provided during the inpatient stay ^[1]. Do not use 0111 if the stay is still ongoing and you need to submit an interim claim (use 0112 for first interim, 0113 for continuing, or 0114 for last interim). Also avoid using 0111 for late charges only (use 0115) or for replacement or void claims (use 0117 or 0118). The code is specifically for hospital inpatient Part A claims; Providers should verify that the patient’s admission meets inpatient criteria and that the claim covers the full stay before selecting 0111 ^[1].

Step-by-Step Claim Example

Consider a patient admitted to a general acute care hospital on January 10 for a three‑day stay and discharged on January 13. The hospital will submit a single claim for the entire inpatient stay. To determine the correct Type of Bill:

1. Leading zero – always included as the first digit (ignored by CMS) ^[1].
2. Facility type (2nd digit) – the facility is a hospital, so digit = 1 ^[1].
3. Type of care (3rd digit) – the patient is covered under Medicare Part A inpatient benefits, so digit = 1 (Inpatient Part A) ^[1].
4. Frequency (4th digit) – the claim covers the entire stay from admission to discharge with no interim billing, so digit = 1 (Admit Through Discharge) ^[1].

The resulting code is 0111. The provider enters this code in Field 4 of the UB‑04 claim form. After submission, the payer processes the claim as a complete inpatient episode. This example illustrates the straightforward application of 0111 for a typical inpatient stay.

Common Mistakes & Audit Red Flags

Several errors can occur when using Type of Bill code 0111, leading to claim denials or audit scrutiny:

• Using 0111 for interim billing – If a stay is still in progress and the provider submits an interim claim, the correct frequency is 2 (first interim), 3 (continuing), or 4 (last interim). Using 0111 for an incomplete stay is a common mistake ^[1].
• Confusing Part A vs. Part B – Code 0111 is specifically for Inpatient Part A. If the patient is only eligible for Part B inpatient services (e.g., no Part A coverage), the type of care digit should be 2 (Inpatient Part B), not 1. Using 0111 incorrectly can trigger a Medicare audit ^[1].
• Late charges appended to a completed stay – If additional charges arise after the discharge claim has been submitted, use frequency 5 (Late Charge Only) instead of resubmitting with 0111. Submitting a duplicate 0111 claim for late charges may be considered duplicate billing.
• Incorrect facility type – Ensure the facility is indeed a hospital (digit 1). For example, a skilled nursing facility inpatient stay would use a different second digit (2) ^[1].
• Missing leading zero – Although the leading zero is ignored by CMS, it must be present. Omitting it results in an invalid code.

Auditors often flag claims where the TOB does not match the statement covers period or where multiple claims with 0111 overlap for the same patient and dates. Always verify that the frequency digit accurately reflects the claim’s purpose.

Related Codes/Fields

The following table lists related Type of Bill codes for hospital inpatient claims, all sharing the same facility and care digits (1 and 1) but differing in frequency. These codes are defined in the Noridian Bill Types source.

Code	Meaning	Source
0111	Hospital Inpatient Part A – Admit Through Discharge	[1]
0112	Hospital Inpatient Part A – Interim First Claim	[1]
0113	Hospital Inpatient Part A – Interim Continuing Claims	[1]
0114	Hospital Inpatient Part A – Interim Last Claim	[1]
0115	Hospital Inpatient Part A – Late Charge Only	[1]
0117	Hospital Inpatient Part A – Replacement of Prior Claim	[1]
0118	Hospital Inpatient Part A – Void/Cancel of Prior Claim	[1]

Other related fields on the UB‑04 include Field 6 (Statement Covers Period), which must align with the admission and discharge dates for code 0111, and Field 8 (Patient Name). The leading zero in the TOB is a required placeholder and should not be omitted ^[1].

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References

[1] Noridian Bill Types — https://med.noridianmedicare.com/web/jea/topics/claim-submission/bill-types