Knowledge Base Article

CMS recently released MLN Matters Article SE1117 that describes significant changes in the reporting of the Admission Date and Statement Covers Period (from/through dates) on the UB-04.

Effective October 1, 2011, providers should use the following definitions for these form locators (FLs):

• Admission Date (FL12) – the date the patient was admitted as an inpatient to the facility. (This is the date the patient is formally admitted, i.e. the day an order is written to admit the patient as an inpatient).
• Statement Covers Period (“From” and “Through” dates in FL 6) – span of service dates included on the claim. The “From” Date is the earliest date of service on the bill.

Medicare Fiscal Intermediary Shared System (FISS) edits will be changed to accommodate these new definitions so that:

• These two data elements are not required to match, and
• The number of days in the Statement Covers Period will not be compared to any other data element (e.g. total accommodation days reported in the revenue code section).

Providers should review this information carefully and make sure practices and systems are changed as needed to meet these new definitions October 1, 2011. For complete information, please refer to the MLN Matters article.