UB04 Type of Bill Code 0117: Hospital Inpatient (Including Medicare Part A) - Replacement of Prior Claim

Introduction

Type of Bill Code 0117 identifies a claim for a Hospital Inpatient (Including Medicare Part A) that serves as a Replacement of a Prior Claim. This code is reported in Field 4: Type of Bill.

Usage

This code is utilized by acute care hospitals when an original inpatient claim was previously submitted and processed, but now requires a full replacement to correct errors or update clinical data. It signifies that the current submission should completely supersede the previous claim in the payer's system for the same stay.

Billing Impact

Using this code ensures the original claim is voided and replaced, preventing duplicate billing denials while allowing for the adjustment of DRG assignments or total reimbursement amounts based on corrected documentation.