UB-04/CMS-1450 Billing Codes

UB-04/CMS-1450 Reference Material

Type of Bill Codes (Field 4)

This is a three-digit code; each digit is defined below.

UB-04/CMS-1450 Reference Material  
Type of Bill Codes (Field 4)  
This is a three-digit code; each digit is defined below.  
1st Digit – Type of Facility Code
Hospital 1
Skilled Nursing Facility 2
Home Health 3
Christian Science (Hospital) 4
Christian Science (Extended Care) 5
Intermediate Care 6
Clinic 7
2nd Digit – Bill Classifications (Excluding Clinics & Special Facilities) Code
Inpatient 1
Outpatient 3
Other (For Hospital Referenced Diagnostic Services, or Home Health Not Under a Plan of Treatment) 4
Intermediate Care, Level I 5
Intermediate Care, Level II 6
Intermediate Care, Level III 7
Swing Beds 8
2nd Digit – Bill Classifications (Clinics Only) Code
Rural Health 1
Hospital Based or Independent Renal Dialysis Center 2
Free Standing 3
Other Rehabilitation Facility (ORF) 4
Other 9
2nd Digit – Bill Classifications (Special Facility Only) Code
Hospice (Non-Hospital Based) 1
Hospice (Hospital Based) 2
Ambulatory Surgery Center (ASC) 3
Freestanding Birthing Center 4
3rd Digit – Frequency Code
Admit through Discharge Claim 1
Interim – First Claim 2
Interim – Continuing Claims 3
Interim – Last Claim 4
Late Charge only 5
Adjustment of Prior Claim 6
Replacement of Prior Claim 7
Void/Cancel of Prior Claim 8
Sex Codes (Field 15) Code
Male M
Female F
Unknown U
Marital Status Codes (Field 16) Code
Single S
Married M
Legally Separated X
Divorced D
Widowed W
Unknown U
Life Partner P
Type of Admission Codes (Field 19) Code
Emergency 1
Urgent 2
Elective 3
Newborn 4
Information Not Available 9
Source of Admission Codes Except Newborns (Field 20) Code
Physician Referral 1
Clinic Referral 2
HMO Referral 3
Transfer from a Hospital 4
Transfer from a Skilled Nursing Facility (SNF) 5
Transfer from Another Health Facility 6
Emergency Room 7
Court/Law Enforcement 8
Information Not Available 9
Transfer from Psych Substance Abuse or Rehab Hospital 10
Transfer from a Critical Access Hospital 11
Additional Source of Admission Codes for Newborns (Field 20) Code
Normal Delivery 1
Premature Delivery 2
Sick Baby 3
Extramural Birth 4
Information Not Available 5
Patient Status Codes (Field 22) Code
Discharged to Home or Self-Care (Routine Discharge) 01
Discharged/Transferred to Another Short-Term General Hospital 02
Discharged/Transferred to an SNF 03
Discharged/Transferred to an Intermediate Care Facility (ICF) 04
Discharged/Transferred to Another Type of Institution (Including Distinct Parts) or Referred for Outpatient Services to Another Institution 05
Discharged/Transferred to Home Under Care of Organized Home Health Service Organization 06
Left Against Medical Advise or Discontinued Care 07
Discharged/Transferred to Home Under Care of Home IV Therapy Provider 08
Admitted as an Inpatient to this Hospital 09
Expired (or Did Not Recover-Christian Science Patient) 20
Still a Patient or Expected to Return for Outpatient Services 30
Still Patient to be Defined at State Level, if Necessary 31-39
Expired at Home (for Hospice Care Only) 40
Expired in a Medical Facility such as a Hospital, SNF, ICF or Freestanding Hospice (for Hospice Care Only) 41
Expired, Place Unknown (for Hospice Care Only) 42
Discharged to Hospice-Home 50
Discharged to Hospice-Medical Facility 51
Release of Information Indicator Codes (Field 52) Code
Yes Y
Restricted or Modified Release R
No Release N