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).
|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|