Saturday, June 25, 2011

Type of Bill - 1st Position - 3rd Postion

Type of Bill Codes (Field 4) Required. 

This four-digit alphanumeric code gives three specific pieces of information after a leading zero. CMS will ignore the leading zero. CMS will continue to process three specific pieces of information. The second digit identifies the type of facility. The third classifies the type of care. The fourth indicates the sequence of this bill in this particular episode of care. It is referred to as a “frequency” code.


This is a three-digit code; each digit is defined below.

1 st Digit – Type of Facility Code 

Hospital 1
Skilled Nursing Facility 2
Home Health 3
Christian Science (Hospital) 4
Christian Science (Extended Care) 5
Intermediate Care 6
Clinic 7


2nd Digit – Bill Classifications (Excluding Clinics & Special Facilities) Code

Inpatient 1
Outpatient 3
Other (For Hospital Referenced Diagnostic Services, or Home Health Not Under a Plan of Treatment) 4
Intermediate Care, Level I 5
Intermediate Care, Level II 6
Intermediate Care, Level III 7
Swing Beds 8


2nd Digit – Bill Classifications (Clinics Only) Code

Rural Health 1
Hospital Based or Independent Renal Dialysis Center 2
Free Standing 3
Other Rehabilitation Facility (ORF) 4
Other 9

2nd Digit – Bill Classifications (Special Facility Only) Code

Hospice (Non-Hospital Based) 1
Hospice (Hospital Based) 2
Ambulatory Surgery Center (ASC) 3
Freestanding Birthing Center 4


3rd Digit – Frequency Code
Admit through Discharge Claim 1
Interim – First Claim 2
Interim – Continuing Claims 3
Interim – Last Claim 4
Late Charge only 5
Adjustment of Prior Claim 6
Replacement of Prior Claim 7

Void/Cancel of Prior Claim 8


Place of Service Crosswalk
Type of Bill Located on the National Uniform Billing Committee (NUBC) approved UB-04
Claim Form, also known as CMS-1450, in field 4.
Type of Bill Code (1st position) Identifies the Type of Facility that provided the medical services. The following
are two examples:
Type of Bill 11X, the 1 in position 1 represents services provided at a Hospital
Type of Bill 21X, the 2 in position 1 represents services provided at a Skilled
Nursing facility
Type of Bill Code (2nd
position)
Identifies the Bill Classification. Two examples are as follows:
Type of Bill 11X, the 1 in position 2 represents Inpatient Services
Type of Bill 13X, the 3 in position 2 represents Outpatient Services
Type of Bill Code (3rd
position)
Identifies the Frequency of the Bill. This position is not needed for the crosswalk
mapping.
Place of Service Code The two-digit code that identifies where the medical service was performed. The
Place of Service code is reported in field 27 on the NCCI Medical Data Call.
Place of Service
Description
Provides a description of where the medical service was performed.

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