Type of Bill Codes for the UB-04 Claim Form

Decode the Type of Bill Codes

Type of bill codes are three-digit codes located on the UB-04 claim form that describe the type of bill a provider is submitting to a payer, such as Medicaid or an insurance company. This code is required on line 4 of the UB-04.

Each digit has a specific purpose and is required on all UB-04 claims in field locator 4. Explore what each digit means and what codes look like.

The codes are published in the National Uniform Billing Committee (NUBC) guidelines. Check the current manual for any changes or revisions.

Examples of Bill Types

Medical Facility
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Here are examples of types of bill codes and what they mean.

  • Type of Bill 111 represents a Hospital Inpatient Claim indicating that the claim period covers admit through the patient's discharge.
  • Type of Bill 117 represents a Hospital Inpatient Replacement or Corrected claim to a previously submitted hospital inpatient claim that has paid in order for the payer to reprocess the claim.
  • Type of Bill 138 represents a Hospital Outpatient Void or Cancel of a Prior claim to a previously submitted hospital outpatient claim that has paid in order for the payer to recoup the payment made.
  • Type of Bill 831 represents a Hospital Outpatient Surgery performed in an Ambulatory Surgical Center. For an outpatient surgery performed in a Hospital, the type of bill would be 131 instead of 831.

First Digit of the Bill Type Code - Facility Type

The first digit refers to the type of facility.

1 - Hospital
2 - Skilled Nursing
3 - Home Health
4 - Religious Nonmedical Health Care Facility (Hospital)
5 - Religious Nonmedical Health Care Facility (Extended Care)
7 - Clinic
8 - Specialty Facility, Hospital ASC Surgery

Second Digit of the Bill Type Code

What the second digit signifies depends on the first digit is. It has a different set of meanings for clinics and special facilities.

The second digit refers to the bill classification except for clinics and special facilities.
If the first digit is 1-5, then the second digit is:
1 - Inpatient (Medicare Part A)
2 - Inpatient (Medicare Part B)
3 - Outpatient
4 - Other (Medicare Part B)
5 - Level I Intermediate Care
6 - Level II Intermediate Care
7 - Subacute Inpatient (for use with Revenue Code 019X)
8 - Swing Bed

For Clinics only:
If the first digit is 7, then the second digit is:
1 - Rural Health Clinic
2 - Hospital Based or Independent Renal Dialysis Facility
3 - Federally Qualified Health Center (FQHC), Free Standing Provider-Based
4 - Other Rehabilitation Facility (ORF)
5 - Comprehensive Outpatient Rehabilitation Facility (CORF)
6 - Community Mental Health Center (CMHC)

For Special Facilities Only:
If the first digit is 8, then the second digit is:
1 - Nonhospital Based Hospice
2 - Hospital Based Hospice
3 - Ambulatory Surgical Center Services to Hospital Patients
4 - Other Rehabilitation Facility (ORF)
5 - Comprehensive Outpatient Rehabilitation Facility (CORF)
6 - Community Mental Health Center (CMHC)

Third Digit of the Bill Type Code - Frequency

The third digit refers to the frequency.

0 - Nonpayment or Zero Claims
1 - Admit Through Discharge Claim
2 - Interim (First Claim)
3 - Interim (Continuing Claims)
4 - Interim (Last Claim)
5 - Late Charge Only
7 - Replacement of Prior Claim or Corrected Claim
8 - Void or Cancel of a Prior Claim
9 - Final Claim for a Home Health PPS Episode

Types of Facilities Using the UB-04

  • Community Mental Health Center
  • Comprehensive Outpatient Rehabilitation Facility
  • Critical Access Hospital
  • End-Stage Renal Disease Facility
  • Federally Qualified Health Center
  • Histocompatibility Laboratory
  • Home Health Agency
  • Hospice
  • Hospital
  • Indian Health Services Facility
  • Organ Procurement Organization
  • Outpatient Physical Therapy Services
  • Occupational Therapy Services
  • Speech Pathology Services
  • Religious Non-Medical Health Care Institution
  • Rural Health Clinic
  • Skilled Nursing Facility

Corrected Claims

When making changes to previously paid claims, most corrected claims can be submitted electronically.

  1. Update the Claim Frequency Code with: 7 = Replacement of a prior claim 8 = Void/cancel of a prior claim
  2. Submit the claim using the DCN (document control number) or ICN (internal control number)from the payer's explanation of payment (EOP) or electronic remittance.
  3. If you must submit a corrected claim on paper, make sure the format is correct. Some payers accept the photocopied black-and-white versions of the medical claims but the best process is to submit the original red-and-white version. Depending on the payer, when the original claim form is not used, the claim may not scan into their system properly creating a delay or denial in payment.

    *Make sure the printer is lined properly to ensure that the information is printed in the correct field locations.

    *Do not highlight any information on the claim.

    *Do not handwrite comments on the form such as "Corrected Claim" or "EOB Attached".

    *Do not attach staples, stamps, tapes, sticky notes, paper clip or anything else to the claim forms.

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