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Data Element Name:  UB Accommodation Code
Format-Length:  A/N - 4 Required For:  IP
Effective Date:  1/1/94 Revision Date:  September 2003

National Standard Mapping:

Electronic - 837I

X12 Loop

Ref. Des.

Data Element

Code

Description
Version 4050R 2400 SV201 234 Revenue Code

Paper Form Locator Code Qualifier
Institutional - UB-04 42 N/A

Definition:

The code which identifies the type of accommodation utilized by the patient during the billing period.

Codes and Values:

  1. Must be a valid code in accordance with the Accommodation Codes in Appendix H.

Edit Applications:

  1. If the Accommodation Code is entered, then Accommodations Rate, Accommodations Days, Accommodations Total Charges, and Accommodations Total Non-Covered Charges must also be reported.

  2. It is necessary to report at least one UB Accommodation or one Ancillary with each claim.

  3. SPARCS allows a maximum of 50 Accommodations.
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