Results 1 to 2 of 2

Type of Bill Codes

  1. Default Type of Bill Codes
    New Call-to-action
    I need help!

    Trying to figure out the proper Type of Bill Code to submit on a UB-04 claim form for a Sub-Acute Detox/Residential Substance Abuse Rehab Treatment Center (Inpatient).

    Currently, our Billing Dept is outsourced. They have been using Code 113.

    After receiving a denial on a specific claim I contacted that insurance company. I was told that our Tax ID does not reflect a hospital setting and the first digit for claim type is incorrect and should be replaced with an 8-Specialty Facility. When I contacted the Billing Dept they stated that all those claims were resubmitted with bill type 163.

    If we are not a Hospital how are they getting our claims paid as a "Hospital" setting?

    Please help!

  2. #2
    Location
    Stuart, FL Sailfish Chapter
    Posts
    137
    Default
    Its payer specific.

    Technically you cannot even classify outpatient care at a non residential facility so I have not had an issue using 11x and 13x on my claims. Every once in a while, I will get a payer like GEHA who will want the 86x code. Other payers like Magellan will only accept the 11x and 13x codes and they are specialty MH/SA. If the payer is asking for the 86x code for inpatient residential, then I will just give them what they want. I have gone through many audits, and type of bill codes have never been an issue.

    To be honest, I dont even know what 163 is for since my RCM software doesn't even give me the option. So something tells me those claims are going to deny.

Similar Threads

  1. Type of Bill TOB
    By lboomer in forum Outpatient Facilities
    Replies: 1
    Last Post: 10-23-2014, 07:11 PM
  2. Billing on a UB bill Type 831
    By medicalcoord in forum Billing/Reimbursement
    Replies: 0
    Last Post: 06-12-2013, 08:10 AM
  3. Bill type 0333- help!
    By pvang in forum Medical Coding General Discussion
    Replies: 5
    Last Post: 01-06-2011, 06:41 AM
  4. Type of Bill
    By den71ice in forum Medicare Regulations
    Replies: 0
    Last Post: 02-03-2010, 12:06 PM
  5. Type of Bill on UB04
    By anwalden in forum Outpatient Facilities
    Replies: 3
    Last Post: 12-08-2009, 06:11 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.