UB04 Type of Bill Code 0118: Hospital Inpatient (Including Medicare Part A) - Void/Cancel of Prior Claim

Overview

Type of Bill (TOB) code 0118 is a four-digit alphanumeric code used on the UB-04 claim form to indicate a hospital inpatient (including Medicare Part A) void/cancel of a prior claim. The code is structured with a leading zero (ignored by CMS), the facility digit “1” for hospital, the care digit “1” for inpatient Part A, and the frequency digit “8” for void/cancel of a prior claim ^[1]. According to the Noridian bill-type structure, the second digit identifies the type of facility (1 = hospital), the third digit specifies the type of care (1 = Inpatient Part A for hospitals), and the fourth digit denotes the frequency or sequence (8 = Void/Cancel of Prior Claim) ^[1]. The UB-04 form is the standard paper claim format used by acute inpatient hospitals, as noted in the MassHealth billing guide ^[2]. Code 0118 specifically applies to inpatient Part A services (Medicare Part A) and cannot be used for outpatient, Part B, or other care types unless the facility and care digits are adjusted accordingly.

When to Use

The frequency digit “8” explicitly indicates a void/cancel of a prior claim, as defined in the Noridian bill-type frequency list ^[1]. A void is different from a replacement (frequency code “7”) because a void eliminates the original claim entirely, while a replacement corrects and supersedes it. The MassHealth guide emphasizes that all claims must be submitted electronically unless a waiver is obtained, but for paper submissions, the UB-04 form must be completed accurately ^[2].

Step-by-Step Claim Example

A hospital previously submitted a TOB 0111 (hospital inpatient Part A, admit through discharge) claim for a Medicare beneficiary. After processing, the hospital discovers the patient was actually covered under a different insurance primary and the Medicare Part A claim should not have been filed. To void the original claim, the hospital prepares a new UB-04 form with the following:

• Field 1 (Provider Name, Address, and Identifier): Enter the hospital’s name, address, and Medicare provider number.
• Field 4 (Type of Bill): Enter “0118.”
• Field 5 (Federal Tax Number): Hospital’s tax ID.
• Field 6 (Statement Covers Period): Dates of service from the original claim (admission and discharge dates).
• Field 8a (Patient Name and Address): Patient’s name and address.
• Field 10 (Patient Birthdate and Sex): Patient’s birthdate and sex.

The claim should contain no charges in fields 42–47 (revenue codes, charges, units) because a void cancels all previously reported amounts. The MassHealth guide states that acute inpatient hospitals must use the UB-04 when submitting paper claims ^[2]. After completion, the paper form (if a waiver has been approved) is submitted to the payer. The payer will process the void, reversing all payments and adjustments made on the original claim. Electronic submission equivalents would use the same TOB code in the electronic claim format.

Common Mistakes & Audit Red Flags

A frequent error is using frequency code “7” (replacement of prior claim) instead of “8” (void/cancel) when the intent is to nullify the original claim. The Noridian frequency list clearly distinguishes between replacement (7) and void/cancel (8) ^[1]. Using the wrong code can result in the claim being processed as a correction rather than a cancellation, potentially creating duplicate payments or unresolved discrepancies. Another mistake is including charge amounts on the void claim. A void should have zero charges because it cancels the original financial record. If charges are entered, the payer may reject the void or treat it as a new claim. Audit red flags include submitting a void for a claim that never existed, attempting to void after the payer’s timely filing limit has expired, or using TOB 0118 for non-inpatient services (e.g., outpatient Part B requires a different care digit). Providers should also ensure that the leading zero is correctly placed; the Noridian code structure includes a leading zero that is ignored by CMS, but it must be present on the form ^[1]. Failure to match the original claim’s patient and provider identifiers can cause the void to be rejected. The MassHealth guide advises that all submissions must be accurate to avoid delays ^[2].

Related Codes/Fields

The table below lists other relevant Type of Bill codes and fields that are commonly associated with TOB 0118. All definitions are based on the Noridian bill-type structure ^[1] unless otherwise noted.

Code/Field	Description	Source
TOB 0111	Hospital Inpatient (Part A) – Admit Through Discharge (frequency 1)	[1]
TOB 0117	Hospital Inpatient (Part A) – Replacement of Prior Claim (frequency 7)	[1]
TOB 0118	Hospital Inpatient (Part A) – Void/Cancel of Prior Claim	[1]
TOB 0128	Hospital Inpatient (Part B) – Void/Cancel of Prior Claim (care digit 2)	[1]
TOB 0138	Hospital Outpatient (Part B) – Void/Cancel of Prior Claim (care digit 3)	[1]
Field 4	Type of Bill – Enter the four-digit code (e.g., 0118)	[2]
Field 64	Document Control Number (Original Claim Reference) – May be used to link to prior claim	(Not explicitly detailed in provided sources; common practice)

Note: Fields like Document Control Number are standard on UB-04 but not directly covered in the given sources; they are included for context. ---END---

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References

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

[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download