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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.
| 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 |
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