Which Form Locator is used for the Statement Covers Period field on the UB-04 form?

Which Form Locator is used for the Statement Covers Period field on the UB-04 form?

• A. FL 12
• B. FL 6
• C. FL 8a
• D. FL 9

Answer: (B)

The data for the period covered by the statement goes in the field labeled Statement Covers Period on the UB-04. This field is specifically defined to capture the dates of service that the claim spans, usually as a start and end date, so the payer can verify the billing period. The other form locators are used for different data elements (such as identifiers or other dates), not for the service period, so they don’t fit this data. Therefore, using the field designated for the Statement Covers Period is the correct choice.

The data for the period covered by the statement goes in the field labeled Statement Covers Period on the UB-04. This field is specifically defined to capture the dates of service that the claim spans, usually as a start and end date, so the payer can verify the billing period. The other form locators are used for different data elements (such as identifiers or other dates), not for the service period, so they don’t fit this data. Therefore, using the field designated for the Statement Covers Period is the correct choice.