UB04 Field 52: Release of Info Certification

Overview

Field 52 (Release of Info Certification) on the UB-04 claim form is used to indicate that the provider has obtained the patient's authorization to release medical information necessary for processing the claim. According to the Medicare Claims Processing Manual, this field is part of the standardized UB-04 data set maintained by the National Uniform Billing Committee (NUBC) ^[1]. The field is not required for either inpatient or outpatient claims under Medicare billing instructions. The CMS manual states that "Instructions for completion are the same for inpatient and outpatient claims unless otherwise noted" ^[1]. While the field exists on the form, Medicare does not mandate its completion for claim processing. The MassHealth UB-04 Billing Guide similarly does not require this field for MassHealth claims processing ^[2]. Providers should note that the UB-04 form serves "multiple third party payers" and "a particular payer may not need some data elements" ^[1]. Therefore, Field 52 may be left blank for most Medicare and MassHealth claims.

When to Use

Field 52 is typically used when a specific payer requires documentation that the provider has obtained patient authorization to release information. However, for Medicare claims, this field is not required for either inpatient or outpatient billing ^[1]. The CMS manual emphasizes that "The A/B MAC (A) or (HHH) does not need to search paper files to annotate missing data unless it does not have an electronic history record" ^[1]. This means Medicare contractors will not reject claims solely because Field 52 is blank. For MassHealth claims, the billing guide does not provide specific instructions for completing this field, indicating it is not a required element for MassHealth processing ^[2]. Providers should check with individual commercial payers or managed care plans, as some may require this field to be completed. The CMS manual notes that "Where it knows that a managed care plan will pay the bill, it sends the bill and any necessary supporting documentation directly to the managed care plan" ^[1]. In general, Field 52 is rarely used in standard Medicare or MassHealth billing.

Step-by-Step Claim Example

Since Field 52 is not required for Medicare or MassHealth claims, a typical claim submission would leave this field blank. For example, a hospital submitting an inpatient claim for a Medicare beneficiary would complete all required fields (e.g., Type of Bill in Field 4, Patient Name in Field 8, Admission Date in Field 12, etc.) but would not need to enter any data in Field 52 ^[1]. Similarly, an outpatient claim for a MassHealth member would follow the instructions in the MassHealth UB-04 Billing Guide, which does not require Field 52 completion ^[2]. If a commercial payer requires this field, the provider would typically enter a "Y" (Yes) or a date indicating when the release was obtained, depending on the payer's specific requirements. The CMS manual states that "All items on Form CMS-1450 are described" but does not provide specific coding for Field 52 ^[1]. Providers should always verify payer-specific requirements before completing this field.

Common Mistakes & Audit Red Flags

Common mistakes with Field 52 include unnecessarily completing it when not required, which can create confusion or unnecessary data entry. Since Medicare and MassHealth do not require this field, entering incorrect or inconsistent data could trigger audit flags. The CMS manual notes that "The A/B MAC (A) or (HHH) does not need to obtain data that is not needed to process the claim" ^[1]. Another red flag is leaving the field blank when a specific payer requires it, which could result in claim rejection or delay. Providers should also avoid entering dates that conflict with other fields, such as the statement covers period in Field 6. The MassHealth guide emphasizes that all claims must be submitted electronically unless the provider has an approved exception ^[2]. For paper claims, ensure that Field 52 is either left blank or completed exactly as required by the specific payer. Inconsistent data across fields can lead to audit scrutiny.

Related Codes/Fields

Field Number	Field Name	Description	Requirement
Field 6	Statement Covers Period	Dates of service for the claim	Required for all claims
Field 8	Patient Name	Patient's full name	Required for all claims
Field 12	Admission/Start of Care Date	Date of admission or start of care	Required for inpatient claims
Field 13	Admission Hour	Hour of admission	Required for inpatient claims
Field 14	Priority (Type) of Admission	Type of admission (e.g., emergency, urgent)	Required for inpatient claims
Field 15	Point of Origin	Source of admission	Required for inpatient claims
Field 17	Patient Discharge Status	Discharge status code	Required for inpatient claims
Field 18-28	Condition Codes	Codes describing special conditions	As applicable
Field 31-36	Occurrence Codes/Dates	Dates of specific events	As applicable
Field 39-41	Value Codes/Amounts	Monetary values related to the claim	As applicable
Field 42	Revenue Code	Revenue center code	Required for each line item
Field 44	HCPCS/Rate	Procedure code	Required for outpatient claims
Field 50	Payer Identification	Payer identifier	Required for all claims
Field 52	Release of Info Certification	Patient authorization indicator	Not required for Medicare/MassHealth
Field 53	Assignment of Benefits	Assignment indicator	Not required for Medicare/MassHealth

Note: All field requirements are based on CMS Chapter 25 and MassHealth UB-04 Guide instructions.

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References

[1] CMS Chapter 25 — https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c25.pdf

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