Which Form Locator is required for Admission Date on the UB-04 form?

Which Form Locator is required for Admission Date on the UB-04 form?

• A. FL 12
• B. FL 5
• C. FL 8a
• D. FL 9

Answer: (A)

Admission date is captured in a specific slot of the UB-04 called a Form Locator, and the slot designated for the admission date is Form Locator 12. This field is set aside to record the date the patient was admitted, which is essential for establishing the length of stay and determining inpatient status for the claim. The other listed form locators are assigned to different data elements, so they do not represent the admission date. Therefore, the admission date must be entered in Form Locator 12.

Admission date is captured in a specific slot of the UB-04 called a Form Locator, and the slot designated for the admission date is Form Locator 12. This field is set aside to record the date the patient was admitted, which is essential for establishing the length of stay and determining inpatient status for the claim. The other listed form locators are assigned to different data elements, so they do not represent the admission date. Therefore, the admission date must be entered in Form Locator 12.