UB04 Field 76: Attending Name/ID

Overview

Field 76 (Box 76) of the UB‑04 claim form is titled Attending Provider Name and Identifiers (including NPI). It captures the individual clinician who has overall responsibility for the patient’s medical care and treatment during the billed encounter. ^[1] defines the attending provider as “the individual who has overall responsibility for the patient’s medical care and treatment reported in this claim/encounter.” The field is situational — it is required only when the claim or encounter contains services other than nonscheduled transportation services; otherwise, the field should not be sent. ^[1] This rule is echoed in ^[2], which states “FL 76 - Attending Provider Name and Identifiers (including NPI) Situational.” The Maryland Medicaid UB‑04 hospital billing instructions refer to the field as “Attending Provider Name and Identifiers” on page 47 of their manual, confirming its presence on the form. ^[3] The field applies to both inpatient and outpatient settings, noted as “If Applicable” in the field’s header. Proper completion of Box 76 is critical for accurate claim adjudication and provider attribution.

When to Use

Field 76 must be completed whenever the claim or encounter includes any services other than nonscheduled transportation (e.g., ambulance transport without a scheduled appointment). ^[1] For inpatient claims, the attending physician is the physician with primary responsibility for the patient’s care during the entire stay. For outpatient services, it is the physician who oversees the particular episode of care reported on the claim. The field is situational; if the claim consists solely of nonscheduled transportation, do not populate Field 76. ^[1] Both ^[2] and ^[1] emphasize that the field is not optional for most encounters — it is required under the described condition. Maryland Medicaid’s instructions list the field on page 47, indicating it is expected on all applicable UB‑04 submissions. ^[3] The field is separate from the operating physician (Box 77) and other physicians (Boxes 78–79), so the correct attending must be listed here.

Step-by-Step Claim Example

Consider a 5‑day inpatient stay for pneumonia. The attending physician is Dr. Jane Smith, NPI 1234567890.

1. On the UB‑04, locate Box 76 — it contains three vertical sub‑columns: QUAL (qualifier), ID (identifier), and NAME.
2. In the ID column, enter 1234567890.
3. In the NAME column, enter the attending’s last name first, a comma, then first name and optional middle initial: Smith, Jane.
4. Ensure no other physician is entered here; the attending must be the one with overall responsibility. ^[1]
5. Verify that the claim does not consist solely of nonscheduled transportation — it does not, so Field 76 is required. ^[1]
6. Double‑check that the NPI is correctly reported without dashes or spaces, and that the name matches the provider’s enrollment records (e.g., NPI registry).
7. If the claim were only for an ambulance transport without a scheduled appointment, Field 76 would be left blank. ^[2]

This example demonstrates the standard layout and data required for Field 76 as per CMS guidance.

Common Mistakes & Audit Red Flags

1. Omitting Field 76 when required — The most common error is leaving Box 76 blank on inpatient or outpatient claims that include services other than nonscheduled transportation. CMS expects the attending provider to be identified; missing data can lead to claim rejection or audit risk. ^[1]
2. Entering the wrong physician — Listing a consulting physician, operating physician, or resident instead of the attending who has overall responsibility is incorrect. The attending is the clinician managing the patient’s entire stay or episode. ^[1]
3. Using an invalid NPI qualifier — The qualifier must be “0B” for NPI when reporting an NPI in the ID field. Using a blank or different qualifier (e.g., “1A”) may cause the identifier to be misread.
4. Name formatting errors — Names should be in “Last, First” order. Misspellings or use of nicknames may trigger payer‑side matches against provider directories, causing denials.
5. Including Field 76 on transportation‑only claims — Some billers populate the field on all claims, but CMS says the field must be omitted when the claim contains only nonscheduled transportation services. ^[2] Including it unnecessarily may not cause rejection, but the data will be ignored and could confuse downstream processes.
6. Mismatch between NPI and name — If the NPI in the ID column belongs to a different provider than the name entered, the claim may be denied or flagged for audit.
7. Failure to update when attending changes — For long stays where the attending changes, the provider listed should be the one responsible for the period covered by the claim. Check payer specific guidance.

Related Codes/Fields (markdown table)

Field Number	Field Name	Relationship to Field 76
Box 77	Operating Physician NPI/Name	Identifies the surgeon for surgical procedures; distinct from attending (overall care) [1]
Box 78 & 79	Other Physician IDs (QUAL/NPI/ID)	Used for additional providers (e.g., referring, ordering) — not the attending [1]
Box 56	NPI – Billing Provider	Identifies the facility, not the attending; both are required on the claim [3]
Box 67	Principal Diagnosis Code	The attending’s diagnosis drives coding; Field 76 shows who is responsible for that condition
Box 71	PPS Code	Indicates payment method; attending attribution can affect PPS outlier calculations
Box 63	Treatment Authorization Code	May link to attending’s prior authorization for certain services
Box 1–3	Provider Name, Address, ID	Facility identification; complements attending identification in Field 76
Box 74	Principal Procedure Code & Date	If a procedure is performed, the attending is distinct from the operating physician listed in Box 77

All citations refer to the source documents used in this article.

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References

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

[2] CMS R1915CP — https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1915CP.pdf

[3] Maryland Medicaid — FL 76 — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf