Claim Frequency Code (FFS)

SAS Name

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. 


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).

Source: NCH

Code Code value
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 debt/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
M Medicare secondary payer (MSP) adjustment
P Adjustment required by QIO