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This variable is contained in the following files:
SAS Name
CLM_FREQ_CD
The third digit of the type of bill (TOB3) submitted on an institutional claim record to indicate the sequence of a claim in the beneficiary's current episode of care.
Source: NCH
| Code | Code value |
|---|---|
| 0 | Non-payment/zero claims |
| 1 | Admit thru discharge claim |
| 2 | Interim — first claim |
| 3 | Interim — continuing claim |
| 4 | Interim — last claim |
| 5 | Late charge(s) only claim |
| 7 | Replacement of prior claim |
| 8 | Void/cancel prior claim |
| 9 | Final claim (for HH PPS = process as a debit/credit to RAP claim) |
| G | Common Working File (NCH) generated adjustment claim |
| H | CMS generated adjustment claim |
| I | Misc. adjustment claim (e.g., initiated by intermediary or QIO) |
| J | Other adjustment request |
| K | OIG Initiated Adjustment Claim |
| M | Medicare secondary payer (MSP) adjustment |
| P | Adjustment required by QIO |
| Q | Claim Submitted for Reconsideration Outside of Timely Limits |
| Y | Replacement of prior abbreviated encounter submission |
This field can be used in determining the “type of bill” for an institutional claim. Often type of bill consists of a combination of two variables: the facility type code (variable called CLM_FAC_TYPE_CD) and the service classification type code (CLM_SRVC_CLSFCTN_TYPE_CD). This variable serves as the optional third component of bill type, and it is helpful for distinguishing between final, interim, or RAP (request for anticipated payment) claims, which is particularly helpful if you receive claims that are not “final action.”
Many different types of services can be billed on a Part A or Part B institutional claim and knowing the type of bill helps to distinguish them. The type of bill is the concatenation of three variables: the facility type (CLM_FAC_TYPE_CD), the service classification type code (CLM_SRVC_CLSFCTN_TYPE_CD), and the claim frequency code (CLM_FREQ_CD).