Value|Description|Category
000|Medicaid Custom Bill Type|Medicaid Custom Bill Type
001|Medicaid Custom Bill Type|Medicaid Custom Bill Type
002|Medicaid Custom Bill Type|Medicaid Custom Bill Type
003|Medicaid Custom Bill Type|Medicaid Custom Bill Type
007|Medicaid Custom Bill Type|Medicaid Custom Bill Type
008|Medicaid Custom Bill Type|Medicaid Custom Bill Type
00F|Medicaid Custom Bill Type|Medicaid Custom Bill Type
010|Medicaid Custom Bill Type|Medicaid Custom Bill Type
011|Medicaid Custom Bill Type|Medicaid Custom Bill Type
012|Medicaid Custom Bill Type|Medicaid Custom Bill Type
013|Medicaid Custom Bill Type|Medicaid Custom Bill Type
014|Medicaid Custom Bill Type|Medicaid Custom Bill Type
019|Medicaid Custom Bill Type|Medicaid Custom Bill Type
020|Medicaid Custom Bill Type|Medicaid Custom Bill Type
021|Medicaid Custom Bill Type|Medicaid Custom Bill Type
022|Medicaid Custom Bill Type|Medicaid Custom Bill Type
023|Medicaid Custom Bill Type|Medicaid Custom Bill Type
024|Medicaid Custom Bill Type|Medicaid Custom Bill Type
025|Medicaid Custom Bill Type|Medicaid Custom Bill Type
026|Medicaid Custom Bill Type|Medicaid Custom Bill Type
027|Medicaid Custom Bill Type|Medicaid Custom Bill Type
030|Medicaid Custom Bill Type|Medicaid Custom Bill Type
031|Medicaid Custom Bill Type|Medicaid Custom Bill Type
032|Medicaid Custom Bill Type|Medicaid Custom Bill Type
033|Medicaid Custom Bill Type|Medicaid Custom Bill Type
041|Medicaid Custom Bill Type|Medicaid Custom Bill Type
042|Medicaid Custom Bill Type|Medicaid Custom Bill Type
051|Medicaid Custom Bill Type|Medicaid Custom Bill Type
052|Medicaid Custom Bill Type|Medicaid Custom Bill Type
061|Medicaid Custom Bill Type|Medicaid Custom Bill Type
071|Medicaid Custom Bill Type|Medicaid Custom Bill Type
072|Medicaid Custom Bill Type|Medicaid Custom Bill Type
073|Medicaid Custom Bill Type|Medicaid Custom Bill Type
076|Medicaid Custom Bill Type|Medicaid Custom Bill Type
082|Medicaid Custom Bill Type|Medicaid Custom Bill Type
083|Medicaid Custom Bill Type|Medicaid Custom Bill Type
085|Medicaid Custom Bill Type|Medicaid Custom Bill Type
089|Medicaid Custom Bill Type|Medicaid Custom Bill Type
091|Medicaid Custom Bill Type|Medicaid Custom Bill Type
0PT|Medicaid Custom Bill Type|Medicaid Custom Bill Type
100|Medicaid Custom Bill Type|Medicaid Custom Bill Type
101|Medicaid Custom Bill Type|Medicaid Custom Bill Type
103|Medicaid Custom Bill Type|Medicaid Custom Bill Type
107|Medicaid Custom Bill Type|Medicaid Custom Bill Type
110|NONPAYMENT/ZERO CLAIMS|HOSPITAL INPAT(PART A)
111|REGULAR INPATIENT|HOSPITAL INPAT(PART A)
112|FIRST PORTION: CONTINUOUS STAY INPATIENT CLAIM|HOSPITAL INPAT(PART A)
113|SUBSEQUENT PORTION: CONTINUOUS STAY INPATIENT CLAIM|HOSPITAL INPAT(PART A)
114|FINAL PORTION: CONTINUOUS STAY INPATIENT CLAIM|HOSPITAL INPAT(PART A)
115|INPATIENT: LATE CHARGE(S) ONLY CLAIM|HOSPITAL INPAT(PART A)
116|INPATIENT: ADJUSTMENT OR PRIOR CLAIM NEEDED|HOSPITAL INPAT(PART A)
117|INPATIENT: REPLACEMENT OF PRIOR CLAIM|HOSPITAL INPAT(PART A)
118|INPATIENT: VOID/CANCEL OF PRIOR CLAIM|HOSPITAL INPAT(PART A)
119|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|HOSPITAL INPAT(PART A)
11A|ADMISSION/ELECTION NOTICE|HOSPITAL INPAT(PART A)
11B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOSPITAL INPAT(PART A)
11C|HOSPICE CHANGE OF PROVIDER NOTICE|HOSPITAL INPAT(PART A)
11D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOSPITAL INPAT(PART A)
11E|HOSPICE CHANGE OF OWNERSHIP|HOSPITAL INPAT(PART A)
11F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART A)
11G|CWF INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART A)
11H|CMS INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART A)
11I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOSPITAL INPAT(PART A)
11J|INITIATED ADJUSTMENT CLAIM-OTHER|HOSPITAL INPAT(PART A)
11K|OIG INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART A)
11M|MSP INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART A)
11P|QIO ADJUSTMENT CLAIM|HOSPITAL INPAT(PART A)
11Q|Reopening/Adjustment when the submission falls outside of period to submit an adjustment bill|HOSPITAL INPAT(PART A)
11X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOSPITAL INPATIENT (PART A) SETTINGS|HOSPITAL INPAT(PART A)
120|NONPAYMENT/ZERO CLAIMS|HOSPITAL INPAT(PART B)
121|HOSPITAL INPATIENT (MEDICARE PART B ONLY): ADMIT THROUGH DISCHARGE|HOSPITAL INPAT(PART B)
122|HOSPITAL INPATIENT (MEDICARE PART B ONLY): INTERIM, FIRST CLAIM|HOSPITAL INPAT(PART B)
123|HOSPITAL INPATIENT (MEDICARE PART B ONLY): INTERIM, CONTINUING CLAIM|HOSPITAL INPAT(PART B)
124|HOSPITAL INPATIENT (MEDICARE PART B ONLY): INTERIM, FINAL CLAIM|HOSPITAL INPAT(PART B)
125|HOSPITAL INPATIENT (MEDICARE PART B ONLY): LATE CHARGE(S) ONLY CLAIM|HOSPITAL INPAT(PART B)
126|HOSPITAL INPATIENT (MEDICARE PART B ONLY): Reserved (discontinued as of 10/01/00)|HOSPITAL INPAT(PART B)
127|HOSPITAL INPATIENT (MEDICARE PART B ONLY): REPLACEMENT OF PRIOR CLAIM|HOSPITAL INPAT(PART B)
128|HOSPITAL INPATIENT (MEDICARE PART B ONLY): VOID/CANCEL OF PRIOR CLAIM|HOSPITAL INPAT(PART B)
129|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|HOSPITAL INPAT(PART B)
12A|ADMISSION/ELECTION NOTICE|HOSPITAL INPAT(PART B)
12B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOSPITAL INPAT(PART B)
12C|HOSPICE CHANGE OF PROVIDER NOTICE|HOSPITAL INPAT(PART B)
12D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOSPITAL INPAT(PART B)
12E|HOSPICE CHANGE OF OWNERSHIP|HOSPITAL INPAT(PART B)
12F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART B)
12G|CWF INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART B)
12H|CMS INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART B)
12I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOSPITAL INPAT(PART B)
12J|INITIATED ADJUSTMENT CLAIM-OTHER|HOSPITAL INPAT(PART B)
12K|OIG INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART B)
12M|MSP INITIATED ADJUSTMENT CLAIM|HOSPITAL INPAT(PART B)
12P|QIO ADJUSTMENT CLAIM|HOSPITAL INPAT(PART B)
12Q|Reopening/Adjustment|HOSPITAL INPAT(PART B)
12X|HOSPITAL INPATIENT (MEDICARE PART B ONLY): OTHER NON-SIGNIFICANT PROCEDURES PERFORMED|HOSPITAL INPAT(PART B)
130|NONPAYMENT/ZERO CLAIMS|OUTPATIENT HOSPITAL
131|REGULAR OUTPATIENT|OUTPATIENT HOSPITAL
132|FIRST INTERIM: CONTINUING OUTPATIENT CLAIM|OUTPATIENT HOSPITAL
133|SUBSEQUENT INTERIM: CONTINUING OUTPATIENT CLAIM|OUTPATIENT HOSPITAL
134|FINAL INTERIM: OUTPATIENT CLAIM|OUTPATIENT HOSPITAL
135|OUTPATIENT: LATE CHARGE(S) ONLY CLAIM|OUTPATIENT HOSPITAL
136|OUTPATIENT: ADJUSTMENT OF PRIOR CLAIM|OUTPATIENT HOSPITAL
137|OUTPATIENT: REPLACEMENT OF PRIOR CLAIM|OUTPATIENT HOSPITAL
138|OUTPATIENT: VOID/CANCEL OF PRIOR CLAIMS|OUTPATIENT HOSPITAL
139|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|OUTPATIENT HOSPITAL
13A|ADMISSION/ELECTION NOTICE|OUTPATIENT HOSPITAL
13B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|OUTPATIENT HOSPITAL
13C|HOSPICE CHANGE OF PROVIDER NOTICE|OUTPATIENT HOSPITAL
13D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|OUTPATIENT HOSPITAL
13E|HOSPICE CHANGE OF OWNERSHIP|OUTPATIENT HOSPITAL
13F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|OUTPATIENT HOSPITAL
13G|CWF INITIATED ADJUSTMENT CLAIM|OUTPATIENT HOSPITAL
13H|CMS INITIATED ADJUSTMENT CLAIM|OUTPATIENT HOSPITAL
13I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|OUTPATIENT HOSPITAL
13J|INITIATED ADJUSTMENT CLAIM-OTHER|OUTPATIENT HOSPITAL
13K|OIG INITIATED ADJUSTMENT CLAIM|OUTPATIENT HOSPITAL
13M|MSP INITIATED ADJUSTMENT CLAIM|OUTPATIENT HOSPITAL
13P|QIO ADJUSTMENT CLAIM|OUTPATIENT HOSPITAL
13Q|Reopening/Adjustment|OUTPATIENT HOSPITAL
13X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOSPITAL OUTPATIENT SETTINGS|OUTPATIENT HOSPITAL
140|NONPAYMENT/ZERO CLAIMS|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
141|OUTPATIENT DIAGNOSTIC: ADMIT THROUGH DISCHARGE|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
142|OUTPATIENT DIAGNOSTIC: INTERIM, FIRST CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
143|OUTPATIENT DIAGNOSTIC: INTERIM, CONTINUING CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
144|OUTPATIENT DIAGNOSTIC: INTERIM, FINAL CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
145|OUTPATIENT DIAGNOSTIC: LATE CHARGE(S) ONLY CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
146|OUTPATIENT DIAGNOSTIC: ADJUSTMENT OF PRIOR CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
147|OUTPATIENT DIAGNOSTIC: REPLACEMENT OF PRIOR CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
148|OUTPATIENT DIAGNOSTIC: VOID/CANCEL OF PRIOR CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
149|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14A|ADMISSION/ELECTION NOTICE|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14C|HOSPICE CHANGE OF PROVIDER NOTICE|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14E|HOSPICE CHANGE OF OWNERSHIP|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14G|CWF INITIATED ADJUSTMENT CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14H|CMS INITIATED ADJUSTMENT CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14J|INITIATED ADJUSTMENT CLAIM-OTHER|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14K|OIG INITIATED ADJUSTMENT CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14M|MSP INITIATED ADJUSTMENT CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14P|QIO ADJUSTMENT CLAIM|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14Q|Reopening/Adjustment|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
14X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOSPITAL OUTPATIENT SETTINGS|OUTPATIENT DIAGNOSTIC (NON TREATMENT PLAN)
150|Hospital -Intermedicate care Level I -Nonpayment/zero claim|Hospital -Intermedicate care Level I
151|Hospital -Intermedicate care Level I -Admit thru discharge claim|Hospital -Intermedicate care Level I
152|Hospital -Intermedicate care Level I -Interim first claim|Hospital -Intermedicate care Level I
153|Hospital -Intermedicate care Level I -Interim continuing claim|Hospital -Intermedicate care Level I
154|Hospital -Intermedicate care Level I -Interim last claim|Hospital -Intermedicate care Level I
155|Hospital -Intermedicate care Level I -Late-charge(s)-only claim|Hospital -Intermedicate care Level I
156|Hospital -Intermedicate care Level I -Reserved (discontinued as of 10/01/00)|Hospital -Intermedicate care Level I
157|Hospital -Intermedicate care Level I -Replacement of prior claim|Hospital -Intermedicate care Level I
158|Hospital -Intermedicate care Level I -Void/cancel of prior claim|Hospital -Intermedicate care Level I
159|Hospital -Intermedicate care Level I -Final claim for a home health PPS episode|Hospital -Intermedicate care Level I
160|Hospital -Intermedicate care Level II -Nonpayment/zero claim|Hospital -Intermedicate care Level II
161|Hospital -Intermedicate care Level II -Admit thru discharge claim|Hospital -Intermedicate care Level II
162|Hospital -Intermedicate care Level II -Interim first claim|Hospital -Intermedicate care Level II
163|Hospital -Intermedicate care Level II -Interim continuing claim|Hospital -Intermedicate care Level II
164|Hospital -Intermedicate care Level II -Interim last claim|Hospital -Intermedicate care Level II
165|Hospital -Intermedicate care Level II -Late-charge(s)-only claim|Hospital -Intermedicate care Level II
166|Hospital -Intermedicate care Level II -Reserved (discontinued as of 10/01/00)|Hospital -Intermedicate care Level II
167|Hospital -Intermedicate care Level II -Replacement of prior claim|Hospital -Intermedicate care Level II
168|Hospital -Intermedicate care Level II -Void/cancel of prior claim|Hospital -Intermedicate care Level II
169|Hospital -Intermedicate care Level II -Final claim for a home health PPS episode|Hospital -Intermedicate care Level II
170|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Nonpayment/zero claim|Hospital -Subacute inpatient
171|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Admit thru discharge claim|Hospital -Subacute inpatient
172|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Interim first claim|Hospital -Subacute inpatient
173|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Interim continuing claim|Hospital -Subacute inpatient
174|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Interim last claim|Hospital -Subacute inpatient
175|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Late-charge(s)-only claim|Hospital -Subacute inpatient
176|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Reserved (discontinued as of 10/01/00)|Hospital -Subacute inpatient
177|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Replacement of prior claim|Hospital -Subacute inpatient
178|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Void/cancel of prior claim|Hospital -Subacute inpatient
179|Hospital -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Final claim for a home health PPS episode|Hospital -Subacute inpatient
180|NONPAYMENT/ZERO CLAIMS|HOSPITAL SWING BEDS
181|HOSPITAL SWING BEDS: ADMIT THROUGH DISCHARGE|HOSPITAL SWING BEDS
182|HOSPITAL SWING BEDS: INTERIM, FIRST CLAIM|HOSPITAL SWING BEDS
183|HOSPITAL SWING BEDS: INTERIM, CONTINUING CLAIM|HOSPITAL SWING BEDS
184|HOSPITAL SWING BEDS: INTERIM, FINAL CLAIM|HOSPITAL SWING BEDS
185|HOSPITAL SWING BEDS: LATE CHARGE(S) ONLY CLAIM|HOSPITAL SWING BEDS
186|Hospital -Swing beds -Reserved (discontinued as of 10/01/00)|HOSPITAL SWING BEDS
187|HOSPITAL SWING BEDS: REPLACEMENT OF PRIOR CLAIM|HOSPITAL SWING BEDS
188|HOSPITAL SWING BEDS: VOID/CANCEL OF PRIOR CLAIM|HOSPITAL SWING BEDS
189|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|HOSPITAL SWING BEDS
18A|ADMISSION/ELECTION NOTICE|HOSPITAL SWING BEDS
18B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOSPITAL SWING BEDS
18C|HOSPICE CHANGE OF PROVIDER NOTICE|HOSPITAL SWING BEDS
18D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOSPITAL SWING BEDS
18E|HOSPICE CHANGE OF OWNERSHIP|HOSPITAL SWING BEDS
18F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOSPITAL SWING BEDS
18G|CWF INITIATED ADJUSTMENT CLAIM|HOSPITAL SWING BEDS
18H|CMS INITIATED ADJUSTMENT CLAIM|HOSPITAL SWING BEDS
18I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOSPITAL SWING BEDS
18J|INITIATED ADJUSTMENT CLAIM-OTHER|HOSPITAL SWING BEDS
18K|OIG INITIATED ADJUSTMENT CLAIM|HOSPITAL SWING BEDS
18M|MSP INITIATED ADJUSTMENT CLAIM|HOSPITAL SWING BEDS
18P|QIO ADJUSTMENT CLAIM|HOSPITAL SWING BEDS
18Q|Reopening/Adjustment|HOSPITAL SWING BEDS
18X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOSPITAL SWING BEDS|HOSPITAL SWING BEDS
190|Hospital -Reserved for national assignment -Nonpayment/zero claim|Hospital -Reserved for national assignment
191|Hospital -Reserved for national assignment -Admit thru discharge claim|Hospital -Reserved for national assignment
192|Hospital -Reserved for national assignment -Interim first claim|Hospital -Reserved for national assignment
193|Hospital -Reserved for national assignment -Interim continuing claim|Hospital -Reserved for national assignment
194|Hospital -Reserved for national assignment -Interim last claim|Hospital -Reserved for national assignment
195|Hospital -Reserved for national assignment -Late-charge(s)-only claim|Hospital -Reserved for national assignment
196|Hospital -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Hospital -Reserved for national assignment
197|Hospital -Reserved for national assignment -Replacement of prior claim|Hospital -Reserved for national assignment
198|Hospital -Reserved for national assignment -Void/cancel of prior claim|Hospital -Reserved for national assignment
199|Hospital -Reserved for national assignment -Final claim for a home health PPS episode|Hospital -Reserved for national assignment
200|Medicaid Custom Bill Type|Medicaid Custom Bill Type
201|Medicaid Custom Bill Type|Medicaid Custom Bill Type
210|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING
211|SKILLED NURSING: ADMIT THROUGH DISCHARGE|SKILLED NURSING
212|SKILLED NURSING: INTERIM, FIRST CLAIM|SKILLED NURSING
213|SKILLED NURSING: INTERIM, CONTINUING CLAIM|SKILLED NURSING
214|SKILLED NURSING: FINAL CLAIM|SKILLED NURSING
215|SKILLED NURSING: LATE CHARGE(S) ONLY CLAIM|SKILLED NURSING
216|Skilled nursing -Inpatient (Including Medicare Part A) -Reserved (discontinued as of 10/01/00)|SKILLED NURSING
217|SKILLED NURSING: REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING
218|SKILLED NURSING: VOID/CANCEL OF PRIOR CLAIM|SKILLED NURSING
219|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SKILLED NURSING
21A|ADMISSION/ELECTION NOTICE|SKILLED NURSING
21B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING
21C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING
21D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING
21E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING
21F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING
21G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING
21H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING
21I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING
21J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING
21K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING
21M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING
21P|QIO ADJUSTMENT CLAIM|SKILLED NURSING
21Q|Reopening/Adjustment|SKILLED NURSING
21X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SNF INPATIENT|SKILLED NURSING
220|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING (MEDICARE PART B ONLY)
221|SKILLED NURSING (MEDICARE PART B ONLY): ADMIT THROUGH DISCHARGE|SKILLED NURSING (MEDICARE PART B ONLY)
222|SKILLED NURSING (MEDICARE PART B ONLY): INTERIM, FIRST CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
223|SKILLED NURSING (MEDICARE PART B ONLY): INTERIM, CONTINUING CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
224|SKILLED NURSING (MEDICARE PART B ONLY): FINAL CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
225|SKILLED NURSING (MEDICARE PART B ONLY): LATE CHARGE(S) ONLY CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
226|Skilled nursing -Inpatient (Medicare Part B only) -Reserved (discontinued as of 10/01/00)|SKILLED NURSING (MEDICARE PART B ONLY)
227|SKILLED NURSING (MEDICARE PART B ONLY): REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
228|SKILLED NURSING (MEDICARE PART B ONLY): VOID/CANCEL OF PRIOR CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
229|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SKILLED NURSING (MEDICARE PART B ONLY)
22A|ADMISSION/ELECTION NOTICE|SKILLED NURSING (MEDICARE PART B ONLY)
22B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING (MEDICARE PART B ONLY)
22C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING (MEDICARE PART B ONLY)
22D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING (MEDICARE PART B ONLY)
22E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING (MEDICARE PART B ONLY)
22F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
22G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
22H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
22I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING (MEDICARE PART B ONLY)
22J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING (MEDICARE PART B ONLY)
22K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
22M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
22P|QIO ADJUSTMENT CLAIM|SKILLED NURSING (MEDICARE PART B ONLY)
22Q|Reopening/Adjustment|SKILLED NURSING (MEDICARE PART B ONLY)
22X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SNF INPAT(PART B)|SKILLED NURSING (MEDICARE PART B ONLY)
230|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING OUTPATIENT
231|SKILLED NURSING OUTPATIENT: ADMIT THROUGH DISCHARGE|SKILLED NURSING OUTPATIENT
232|SKILLED NURSING OUTPATIENT: INTERIM, FIRST CLAIM|SKILLED NURSING OUTPATIENT
233|SKILLED NURSING OUTPATIENT: INTERIM, CONTINUING CLAIM|SKILLED NURSING OUTPATIENT
234|SKILLED NURSING OUTPATIENT: FINAL CLAIM|SKILLED NURSING OUTPATIENT
235|SKILLED NURSING OUTPATIENT: LATE CHARGE(S) ONLY CLAIM|SKILLED NURSING OUTPATIENT
236|Skilled nursing -Outpatient -Reserved (discontinued as of 10/01/00)|SKILLED NURSING OUTPATIENT
237|SKILLED NURSING OUTPATIENT: REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING OUTPATIENT
238|SKILLED NURSING OUTPATIENT: VOID/CANCEL OF PRIOR CLAIM|SKILLED NURSING OUTPATIENT
239|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SKILLED NURSING OUTPATIENT
23A|ADMISSION/ELECTION NOTICE|SKILLED NURSING OUTPATIENT
23B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING OUTPATIENT
23C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING OUTPATIENT
23D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING OUTPATIENT
23E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING OUTPATIENT
23F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OUTPATIENT
23G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OUTPATIENT
23H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OUTPATIENT
23I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING OUTPATIENT
23J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING OUTPATIENT
23K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OUTPATIENT
23M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OUTPATIENT
23P|QIO ADJUSTMENT CLAIM|SKILLED NURSING OUTPATIENT
23Q|Reopening/Adjustment|SKILLED NURSING OUTPATIENT
23X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SNF OUTPATIENT|SKILLED NURSING OUTPATIENT
240|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
241|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) ADMIT THROUGH DISCHARGE|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
242|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) INTERIM - FIRST CLAIM USED FOR THE...|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
243|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) INTERIM - CONTINUING CLAIMS|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
244|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) INTERIM - LAST CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
245|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) LATE CHARGE ONLY|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
246|Skilled nursing -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Reserved (discontinued as of 10/01/00)|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
247|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
248|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) VOID/CANCEL OF A PRIOR CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
249|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT) FINAL CLAIM FOR A HOME|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24A|ADMISSION/ELECTION NOTICE|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24P|QIO ADJUSTMENT CLAIM|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24Q|Reopening/Adjustment|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
24X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SKILLED NURSING OTHER|SKILLED NURSING OTHER (FOR HOSPITAL REFERENCED DIAGNOSTIC SERVICES OR HOME HEALTH NOT UNDER A PLAN OF TREATMENT)
250|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING NURSING FACILITY LEVEL I
251|SKILLED NURSING NURSING FACILITY LEVEL I ADMIT THROUGH DISCHARGE|SKILLED NURSING NURSING FACILITY LEVEL I
252|SKILLED NURSING NURSING FACILITY LEVEL I INTERIM - FIRST CLAIM USED FOR THE...|SKILLED NURSING NURSING FACILITY LEVEL I
253|SKILLED NURSING NURSING FACILITY LEVEL I INTERIM - CONTINUING CLAIMS|SKILLED NURSING NURSING FACILITY LEVEL I
254|SKILLED NURSING NURSING FACILITY LEVEL I INTERIM - LAST CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
255|SKILLED NURSING NURSING FACILITY LEVEL I LATE CHARGE ONLY|SKILLED NURSING NURSING FACILITY LEVEL I
256|Skilled nursing -Intermedicate care Level I -Reserved (discontinued as of 10/01/00)|SKILLED NURSING NURSING FACILITY LEVEL I
257|SKILLED NURSING NURSING FACILITY LEVEL I REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
258|SKILLED NURSING NURSING FACILITY LEVEL I VOID/CANCEL OF A PRIOR CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
259|SKILLED NURSING NURSING FACILITY LEVEL I FINAL CLAIM FOR A HOME|SKILLED NURSING NURSING FACILITY LEVEL I
25A|ADMISSION/ELECTION NOTICE|SKILLED NURSING NURSING FACILITY LEVEL I
25B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING NURSING FACILITY LEVEL I
25C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING NURSING FACILITY LEVEL I
25D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING NURSING FACILITY LEVEL I
25E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING NURSING FACILITY LEVEL I
25F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
25G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
25H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
25I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING NURSING FACILITY LEVEL I
25J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING NURSING FACILITY LEVEL I
25K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
25M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
25P|QIO ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL I
25Q|Reopening/Adjustment|SKILLED NURSING NURSING FACILITY LEVEL I
25X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SKILLED NURSING NURSING FACILITY LEVEL I|SKILLED NURSING NURSING FACILITY LEVEL I
260|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING NURSING FACILITY LEVEL II
261|SKILLED NURSING NURSING FACILITY LEVEL II ADMIT THROUGH DISCHARGE|SKILLED NURSING NURSING FACILITY LEVEL II
262|SKILLED NURSING NURSING FACILITY LEVEL II INTERIM - FIRST CLAIM USED FOR THE...|SKILLED NURSING NURSING FACILITY LEVEL II
263|SKILLED NURSING NURSING FACILITY LEVEL II INTERIM - CONTINUING CLAIMS|SKILLED NURSING NURSING FACILITY LEVEL II
264|SKILLED NURSING NURSING FACILITY LEVEL II INTERIM - LAST CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
265|SKILLED NURSING NURSING FACILITY LEVEL II LATE CHARGE ONLY|SKILLED NURSING NURSING FACILITY LEVEL II
266|Skilled nursing -Intermedicate care Level II -Reserved (discontinued as of 10/01/00)|SKILLED NURSING NURSING FACILITY LEVEL II
267|SKILLED NURSING NURSING FACILITY LEVEL II REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
268|SKILLED NURSING NURSING FACILITY LEVEL II VOID/CANCEL OF A PRIOR CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
269|SKILLED NURSING NURSING FACILITY LEVEL II FINAL CLAIM FOR A HOME|SKILLED NURSING NURSING FACILITY LEVEL II
26A|ADMISSION/ELECTION NOTICE|SKILLED NURSING NURSING FACILITY LEVEL II
26B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING NURSING FACILITY LEVEL II
26C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING NURSING FACILITY LEVEL II
26D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING NURSING FACILITY LEVEL II
26E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING NURSING FACILITY LEVEL II
26F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
26G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
26H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
26I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING NURSING FACILITY LEVEL II
26J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING NURSING FACILITY LEVEL II
26K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
26M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
26P|QIO ADJUSTMENT CLAIM|SKILLED NURSING NURSING FACILITY LEVEL II
26Q|Reopening/Adjustment|SKILLED NURSING NURSING FACILITY LEVEL II
26X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SKILLED NURSING NURSING FACILITY LEVEL II|SKILLED NURSING NURSING FACILITY LEVEL II
270|NONPAYMENT/ZERO CLAIMS|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
271|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY ADMIT THROUGH DISCHARGE|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
272|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY INTERIM - FIRST CLAIM USED FOR THE...|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
273|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY INTERIM - CONTINUING CLAIMS|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
274|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY INTERIM - LAST CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
275|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY LATE CHARGE ONLY|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
276|Skilled nursing -Subacute inpatient (revenue code 019X required when this bill type is used  however 019X may be used with other types of bills) -Reserved (discontinued as of 10/01/00)|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
277|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY REPLACEMENT OF PRIOR CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
278|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY VOID/CANCEL OF A PRIOR CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
279|SKILLED NURSING INTERMEDIATE CARE - LEVEL III NURSING FACILITY FINAL CLAIM FOR A HOME|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27A|ADMISSION/ELECTION NOTICE|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27C|HOSPICE CHANGE OF PROVIDER NOTICE|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27E|HOSPICE CHANGE OF OWNERSHIP|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27G|CWF INITIATED ADJUSTMENT CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27H|CMS INITIATED ADJUSTMENT CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27J|INITIATED ADJUSTMENT CLAIM-OTHER|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27K|OIG INITIATED ADJUSTMENT CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27M|MSP INITIATED ADJUSTMENT CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27P|QIO ADJUSTMENT CLAIM|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27Q|Reopening/Adjustment|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
27X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SKILLED NURSING NURSING FACILITY LEVEL III|SKILLED NURSING INTERMEDIATE CARE - LEVEL II
280|NONPAYMENT/ZERO CLAIMS|SNF SWING BED
281|ADMIT THROUGH DISCHARGE CLAIM|SNF SWING BED
282|INTERIM-FIRST CLAIM|SNF SWING BED
283|INTERIM-CONTINUING CLAIMS (NOT VALID FOR PPS BILLS),SNF SWING BED|SNF SWING BED
284|INTERIM-LAST CLAIM (NOT VALID FOR PPS BILLS),SNF SWING BED|SNF SWING BED
285|LATE CHARGE ONLY|SNF SWING BED
286|Skilled nursing -Swing beds -Reserved (discontinued as of 10/01/00)|SNF SWING BED
287|REPLACEMENT OF PRIOR CLAIM|SNF SWING BED
288|VOID/CANCEL OF A PRIOR CLAIM|SNF SWING BED
289|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SNF SWING BED
28A|ADMISSION/ELECTION NOTICE|SNF SWING BED
28B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SNF SWING BED
28C|HOSPICE CHANGE OF PROVIDER NOTICE|SNF SWING BED
28D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SNF SWING BED
28E|HOSPICE CHANGE OF OWNERSHIP|SNF SWING BED
28F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SNF SWING BED
28G|CWF INITIATED ADJUSTMENT CLAIM|SNF SWING BED
28H|CMS INITIATED ADJUSTMENT CLAIM|SNF SWING BED
28I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SNF SWING BED
28J|INITIATED ADJUSTMENT CLAIM-OTHER|SNF SWING BED
28K|OIG INITIATED ADJUSTMENT CLAIM|SNF SWING BED
28M|MSP INITIATED ADJUSTMENT CLAIM|SNF SWING BED
28P|QIO ADJUSTMENT CLAIM|SNF SWING BED
28Q|Reopening/Adjustment|SNF SWING BED
28X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SNF SWING BED|SNF SWING BED
290|Skilled nursing -Reserved for national assignment -Nonpayment/zero claim|Skilled nursing -Reserved for national assignment
291|Skilled nursing -Reserved for national assignment -Admit thru discharge claim|Skilled nursing -Reserved for national assignment
292|Skilled nursing -Reserved for national assignment -Interim first claim|Skilled nursing -Reserved for national assignment
293|Skilled nursing -Reserved for national assignment -Interim continuing claim|Skilled nursing -Reserved for national assignment
294|Skilled nursing -Reserved for national assignment -Interim last claim|Skilled nursing -Reserved for national assignment
295|Skilled nursing -Reserved for national assignment -Late-charge(s)-only claim|Skilled nursing -Reserved for national assignment
296|Skilled nursing -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Skilled nursing -Reserved for national assignment
297|Skilled nursing -Reserved for national assignment -Replacement of prior claim|Skilled nursing -Reserved for national assignment
298|Skilled nursing -Reserved for national assignment -Void/cancel of prior claim|Skilled nursing -Reserved for national assignment
299|Skilled nursing -Reserved for national assignment -Final claim for a home health PPS episode|Skilled nursing -Reserved for national assignment
300|Medicaid Custom Bill Type|Medicaid Custom Bill Type
301|Medicaid Custom Bill Type|Medicaid Custom Bill Type
304|Medicaid Custom Bill Type|Medicaid Custom Bill Type
310|NONPAYMENT/ZERO CLAIMS|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
311|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) ADMIT THROUGH DISCHARGE|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
312|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) INTERIM - FIRST CLAIM USED FOR THE...|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
313|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) INTERIM - CONTINUING CLAIMS|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
314|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) INTERIM - LAST CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
315|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) LATE CHARGE ONLY|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
316|Home health -Inpatient (Including Medicare Part A) -Reserved (discontinued as of 10/01/00)|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
317|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) REPLACEMENT OF PRIOR CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
318|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) VOID/CANCEL OF A PRIOR CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
319|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A) FINAL CLAIM FOR A HOME|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31A|ADMISSION/ELECTION NOTICE|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31P|QIO ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31Q|Reopening/Adjustment|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
31X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)|HOME HEALTH INPATIENT (INCLUDING MEDICARE PART A)
320|NONPAYMENT/ZERO CLAIMS|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
321|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): ADMIT THROUGH DISCHARGE|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
322|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): INTERIM, FIRST CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
323|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): INTERIM, CONTINUING CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
324|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): INTERIM, FINAL CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
325|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): LATE CHARGE(S) ONLY CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
326|Home health -Inpatient (Medicare Part B only) -Reserved (discontinued as of 10/01/00)|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
327|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): REPLACEMENT OF PRIOR CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
328|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): VOID/CANCEL OR PRIOR CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
329|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32A|ADMISSION/ELECTION NOTICE|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32P|QIO ADJUSTMENT CLAIM|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32Q|Reopening/Adjustment|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
32X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH INPATIENT|HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
330|NONPAYMENT/ZERO CLAIMS|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2012
331|COORDINATED HOME CARE: ADMIT THROUGH DISCHARGE|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2013
332|COORDINATED HOME CARE: INTERIM, FIRST CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2014
333|COORDINATED HOME CARE: INTERIM, CONTINUING CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2015
334|COORDINATED HOME CARE: INTERIM, FINAL CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2016
335|COORDINATED HOME CARE: LATE CHARGE(S) ONLY CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2017
336|Home health -Outpatient -Reserved (discontinued as of 10/01/00)|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2017
337|COORDINATED HOME CARE: REPLACEMENT OF PRIOR CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2018
338|COORDINATED HOME CARE: VOID/CANCEL OF PRIOR CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2019
339|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2020
33A|ADMISSION/ELECTION NOTICE|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2021
33B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2022
33C|HOSPICE CHANGE OF PROVIDER NOTICE|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2023
33D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2024
33E|HOSPICE CHANGE OF OWNERSHIP|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2025
33F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2026
33G|CWF INITIATED ADJUSTMENT CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2027
33H|CMS INITIATED ADJUSTMENT CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2028
33I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2029
33J|INITIATED ADJUSTMENT CLAIM-OTHER|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2030
33K|OIG INITIATED ADJUSTMENT CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2031
33M|MSP INITIATED ADJUSTMENT CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2032
33P|QIO ADJUSTMENT CLAIM|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2033
33Q|Reopening/Adjustment|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2033
33X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN COORDINATED HOME CARE|COORDINATED HOME CARE (MEDICARE A TREATMENT PLAN INCLUDING DME) - DISCONTINUED AS OF OCTOBER 1,2034
340|NONPAYMENT/ZERO CLAIMS|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
341|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): ADMIT THROUGH DISCHARGE|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
342|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): INTERIM, FIRST CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
343|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): INTERIM, CONTINUING CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
344|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): INTERIM, FINAL CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
345|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): LATE CHARGE(S) ONLY CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
346|Home health -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Reserved (discontinued as of 10/01/00)|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
347|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): REPLACEMENT OF PRIOR CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
348|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): VOID/CANCEL OF PRIOR CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
349|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34A|ADMISSION/ELECTION NOTICE|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34P|QIO ADJUSTMENT CLAIM|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34Q|Reopening/Adjustment|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
34X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT)|HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT) - DESCRIPTION CHANGE
350|NONPAYMENT/ZERO CLAIMS|HOME HEALTH NURSING FACILITY LEVEL I
351|HOME HEALTH NURSING FACILITY LEVEL I ADMIT THROUGH DISCHARGE|HOME HEALTH NURSING FACILITY LEVEL I
352|HOME HEALTH NURSING FACILITY LEVEL I INTERIM - FIRST CLAIM USED FOR THE...|HOME HEALTH NURSING FACILITY LEVEL I
353|HOME HEALTH NURSING FACILITY LEVEL I INTERIM - CONTINUING CLAIMS|HOME HEALTH NURSING FACILITY LEVEL I
354|HOME HEALTH NURSING FACILITY LEVEL I INTERIM - LAST CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
355|HOME HEALTH NURSING FACILITY LEVEL I LATE CHARGE ONLY|HOME HEALTH NURSING FACILITY LEVEL I
356|Home health -Intermedicate care Level I -Reserved (discontinued as of 10/01/00)|HOME HEALTH NURSING FACILITY LEVEL I
357|HOME HEALTH NURSING FACILITY LEVEL I REPLACEMENT OF PRIOR CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
358|HOME HEALTH NURSING FACILITY LEVEL I VOID/CANCEL OF A PRIOR CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
359|HOME HEALTH NURSING FACILITY LEVEL I FINAL CLAIM FOR A HOME|HOME HEALTH NURSING FACILITY LEVEL I
35A|ADMISSION/ELECTION NOTICE|HOME HEALTH NURSING FACILITY LEVEL I
35B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH NURSING FACILITY LEVEL I
35C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH NURSING FACILITY LEVEL I
35D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH NURSING FACILITY LEVEL I
35E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH NURSING FACILITY LEVEL I
35F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
35G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
35H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
35I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH NURSING FACILITY LEVEL I
35J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH NURSING FACILITY LEVEL I
35K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
35M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
35P|QIO ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL I
35Q|Reopening/Adjustment|HOME HEALTH NURSING FACILITY LEVEL I
35X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH NURSING FACILITY LEVEL I|HOME HEALTH NURSING FACILITY LEVEL I
360|NONPAYMENT/ZERO CLAIMS|HOME HEALTH NURSING FACILITY LEVEL II
361|HOME HEALTH NURSING FACILITY LEVEL II ADMIT THROUGH DISCHARGE|HOME HEALTH NURSING FACILITY LEVEL II
362|HOME HEALTH NURSING FACILITY LEVEL II INTERIM - FIRST CLAIM USED FOR THE...|HOME HEALTH NURSING FACILITY LEVEL II
363|HOME HEALTH NURSING FACILITY LEVEL II INTERIM - CONTINUING CLAIMS|HOME HEALTH NURSING FACILITY LEVEL II
364|HOME HEALTH NURSING FACILITY LEVEL II INTERIM - LAST CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
365|HOME HEALTH NURSING FACILITY LEVEL II LATE CHARGE ONLY|HOME HEALTH NURSING FACILITY LEVEL II
366|Home health -Intermedicate care Level II -Reserved (discontinued as of 10/01/00)|HOME HEALTH NURSING FACILITY LEVEL II
367|HOME HEALTH NURSING FACILITY LEVEL II REPLACEMENT OF PRIOR CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
368|HOME HEALTH NURSING FACILITY LEVEL II VOID/CANCEL OF A PRIOR CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
369|HOME HEALTH NURSING FACILITY LEVEL II FINAL CLAIM FOR A HOME|HOME HEALTH NURSING FACILITY LEVEL II
36A|ADMISSION/ELECTION NOTICE|HOME HEALTH NURSING FACILITY LEVEL II
36B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH NURSING FACILITY LEVEL II
36C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH NURSING FACILITY LEVEL II
36D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH NURSING FACILITY LEVEL II
36E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH NURSING FACILITY LEVEL II
36F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
36G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
36H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
36I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH NURSING FACILITY LEVEL II
36J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH NURSING FACILITY LEVEL II
36K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
36M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
36P|QIO ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL II
36Q|Reopening/Adjustment|HOME HEALTH NURSING FACILITY LEVEL II
36X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH NURSING FACILITY LEVEL II|HOME HEALTH NURSING FACILITY LEVEL II
370|NONPAYMENT/ZERO CLAIMS|HOME HEALTH NURSING FACILITY LEVEL III
371|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY ADMIT THROUGH DISCHARGE|HOME HEALTH NURSING FACILITY LEVEL III
372|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY INTERIM - FIRST CLAIM USED FOR THE...|HOME HEALTH NURSING FACILITY LEVEL III
373|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY INTERIM - CONTINUING CLAIMS|HOME HEALTH NURSING FACILITY LEVEL III
374|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY INTERIM - LAST CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
375|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY LATE CHARGE ONLY|HOME HEALTH NURSING FACILITY LEVEL III
376|Home health -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Reserved (discontinued as of 10/01/00)|HOME HEALTH NURSING FACILITY LEVEL III
377|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY REPLACEMENT OF PRIOR CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
378|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY VOID/CANCEL OF A PRIOR CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
379|HOME HEALTH INTERMEDIATE CARE - LEVEL III NURSING FACILITY FINAL CLAIM FOR A HOME|HOME HEALTH NURSING FACILITY LEVEL III
37A|ADMISSION/ELECTION NOTICE|HOME HEALTH NURSING FACILITY LEVEL III
37B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH NURSING FACILITY LEVEL III
37C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH NURSING FACILITY LEVEL III
37D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH NURSING FACILITY LEVEL III
37E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH NURSING FACILITY LEVEL III
37F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
37G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
37H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
37I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH NURSING FACILITY LEVEL III
37J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH NURSING FACILITY LEVEL III
37K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
37M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
37P|QIO ADJUSTMENT CLAIM|HOME HEALTH NURSING FACILITY LEVEL III
37Q|Reopening/Adjustment|HOME HEALTH NURSING FACILITY LEVEL III
37X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH NURSING FACILITY LEVEL III|HOME HEALTH NURSING FACILITY LEVEL III
380|NONPAYMENT/ZERO CLAIMS|HOME HEALTH SWING BEDS
381|HOME HEALTH SWING BEDS ADMIT THROUGH DISCHARGE|HOME HEALTH SWING BEDS
382|HOME HEALTH SWING BEDS INTERIM - FIRST CLAIM USED FOR THE...|HOME HEALTH SWING BEDS
383|HOME HEALTH SWING BEDS INTERIM - CONTINUING CLAIMS|HOME HEALTH SWING BEDS
384|HOME HEALTH SWING BEDS INTERIM - LAST CLAIM|HOME HEALTH SWING BEDS
385|HOME HEALTH SWING BEDS LATE CHARGE ONLY|HOME HEALTH SWING BEDS
386|Home health -Swing beds -Reserved (discontinued as of 10/01/00)|HOME HEALTH SWING BEDS
387|HOME HEALTH SWING BEDS REPLACEMENT OF PRIOR CLAIM|HOME HEALTH SWING BEDS
388|HOME HEALTH SWING BEDS VOID/CANCEL OF A PRIOR CLAIM|HOME HEALTH SWING BEDS
389|HOME HEALTH SWING BEDS FINAL CLAIM FOR A HOME|HOME HEALTH SWING BEDS
38A|ADMISSION/ELECTION NOTICE|HOME HEALTH SWING BEDS
38B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOME HEALTH SWING BEDS
38C|HOSPICE CHANGE OF PROVIDER NOTICE|HOME HEALTH SWING BEDS
38D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOME HEALTH SWING BEDS
38E|HOSPICE CHANGE OF OWNERSHIP|HOME HEALTH SWING BEDS
38F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOME HEALTH SWING BEDS
38G|CWF INITIATED ADJUSTMENT CLAIM|HOME HEALTH SWING BEDS
38H|CMS INITIATED ADJUSTMENT CLAIM|HOME HEALTH SWING BEDS
38I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOME HEALTH SWING BEDS
38J|INITIATED ADJUSTMENT CLAIM-OTHER|HOME HEALTH SWING BEDS
38K|OIG INITIATED ADJUSTMENT CLAIM|HOME HEALTH SWING BEDS
38M|MSP INITIATED ADJUSTMENT CLAIM|HOME HEALTH SWING BEDS
38P|QIO ADJUSTMENT CLAIM|HOME HEALTH SWING BEDS
38Q|Reopening/Adjustment|HOME HEALTH SWING BEDS
38X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOME HEALTH SWING BEDS|HOME HEALTH SWING BEDS
390|Home health -Reserved for national assignment -Nonpayment/zero claim|Home health -Reserved for national assignment
391|Home health -Reserved for national assignment -Admit thru discharge claim|Home health -Reserved for national assignment
392|Home health -Reserved for national assignment -Interim first claim|Home health -Reserved for national assignment
393|Home health -Reserved for national assignment -Interim continuing claim|Home health -Reserved for national assignment
394|Home health -Reserved for national assignment -Interim last claim|Home health -Reserved for national assignment
395|Home health -Reserved for national assignment -Late-charge(s)-only claim|Home health -Reserved for national assignment
396|Home health -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Home health -Reserved for national assignment
397|Home health -Reserved for national assignment -Replacement of prior claim|Home health -Reserved for national assignment
398|Home health -Reserved for national assignment -Void/cancel of prior claim|Home health -Reserved for national assignment
399|Home health -Reserved for national assignment -Final claim for a home health PPS episode|Home health -Reserved for national assignment
401|Medicaid Custom Bill Type|Medicaid Custom Bill Type
410|NONPAYMENT/ZERO CLAIMS|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
411|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: ADMIT THROUGH DISCHARGE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
412|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: INTERIM FIRST CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
413|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: INTERIM, CONTINUING CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
414|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: INTERIM, FINAL CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
415|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: LATE CHARGE(S) ONLY CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
416|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Including Medicare Part A) -Reserved (discontinued as of 10/01/00)|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
417|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: REPLACEMENT OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
418|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: VOID/CANCEL OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
419|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41A|ADMISSION/ELECTION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41C|HOSPICE CHANGE OF PROVIDER NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41E|HOSPICE CHANGE OF OWNERSHIP|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41G|CWF INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41H|CMS INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41J|INITIATED ADJUSTMENT CLAIM-OTHER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41K|OIG INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41M|MSP INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41P|QIO ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41Q|Reopening/Adjustment|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
41X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTION - HOSPITAL INPATIENT
420|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
421|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
422|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
423|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
424|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
425|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
426|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
427|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
428|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
429|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only) -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Inpatient (Medicare Part B only)
430|NONPAYMENT/ZERO CLAIMS|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
431|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: ADMIT THROUGH DISCHARGE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
432|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: INTERIM FIRST CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
433|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: INTERIM, CONTINUING CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
434|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: INTERIM, FINAL CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
435|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: LATE CHARGE(S) ONLY CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
436|Religious nonmedical health care institutions - hospital inpatient -Outpatient -Reserved (discontinued as of 10/01/00)|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
437|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: REPLACEMENT OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
438|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES: VOID/CANCEL OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
439|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43A|ADMISSION/ELECTION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43C|HOSPICE CHANGE OF PROVIDER NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43E|HOSPICE CHANGE OF OWNERSHIP|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43G|CWF INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43H|CMS INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43J|INITIATED ADJUSTMENT CLAIM-OTHER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43K|OIG INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43M|MSP INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43P|QIO ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43Q|Reopening/Adjustment|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
43X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - OUTPATIENT SERVICES
440|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Other
441|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Other
442|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Other
443|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Other
444|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Other
445|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Other
446|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Other
447|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Other
448|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Other
449|Religious nonmedical health care institutions - hospital inpatient -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Other
450|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
451|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
452|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
453|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
454|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
455|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
456|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
457|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
458|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
459|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level I
460|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
461|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
462|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
463|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
464|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
465|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
466|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
467|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
468|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
469|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Intermedicate care Level II
470|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
471|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
472|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
473|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
474|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
475|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
476|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
477|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
478|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
479|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Subacute inpatient
480|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
481|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
482|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
483|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
484|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
485|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
486|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Swing beds
487|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
488|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Swing beds
489|Religious nonmedical health care institutions - hospital inpatient -Swing beds -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Swing beds
490|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Nonpayment/zero claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
491|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Admit thru discharge claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
492|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Interim first claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
493|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Interim continuing claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
494|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Interim last claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
495|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Late-charge(s)-only claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
496|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
497|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Replacement of prior claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
498|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Void/cancel of prior claim|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
499|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment -Final claim for a home health PPS episode|Religious nonmedical health care institutions - hospital inpatient -Reserved for national assignment
510|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
511|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
512|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
513|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
514|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
515|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
516|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
517|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
518|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
519|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A) -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Including Medicare Part A)
520|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
521|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
522|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
523|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
524|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
525|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
526|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
527|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
528|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
529|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only) -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services  -Inpatient (Medicare Part B only)
530|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
531|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
532|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
533|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
534|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
535|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
536|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
537|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
538|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
539|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services  -Outpatient
540|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
541|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
542|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
543|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
544|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
545|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
546|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services  -Other
547|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
548|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Other
549|Religious nonmedical health care institutions - post hospital extended care services  -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services  -Other
550|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
551|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
552|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
553|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
554|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
555|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
556|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
557|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
558|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
559|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level I
560|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
561|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
562|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
563|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
564|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
565|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
566|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
567|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
568|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
569|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services  -Intermedicate care Level II
570|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
571|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
572|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
573|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
574|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
575|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
576|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Reserved (discontinued as of 10/01|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
579|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Final claim for a home health PPS|Religious nonmedical health care institutions - post hospital extended care services  -Subacute inpatient
580|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services
581|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services
582|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services
583|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services
584|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services
585|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services
586|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services
587|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services
588|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services
589|Religious nonmedical health care institutions - post hospital extended care services  -Swing beds -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services
590|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Nonpayment/zero claim|Religious nonmedical health care institutions - post hospital extended care services
591|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Admit thru discharge claim|Religious nonmedical health care institutions - post hospital extended care services
592|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Interim first claim|Religious nonmedical health care institutions - post hospital extended care services
593|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Interim continuing claim|Religious nonmedical health care institutions - post hospital extended care services
594|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Interim last claim|Religious nonmedical health care institutions - post hospital extended care services
595|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Late-charge(s)-only claim|Religious nonmedical health care institutions - post hospital extended care services
596|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Religious nonmedical health care institutions - post hospital extended care services
597|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Replacement of prior claim|Religious nonmedical health care institutions - post hospital extended care services
598|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Void/cancel of prior claim|Religious nonmedical health care institutions - post hospital extended care services
599|Religious nonmedical health care institutions - post hospital extended care services  -Reserved for national assignment -Final claim for a home health PPS episode|Religious nonmedical health care institutions - post hospital extended care services
601|Medicaid Custom Bill Type|Medicaid Custom Bill Type
610|Intermediate care -Inpatient (Including Medicare Part A) -Nonpayment/zero claim|Intermediate care -Inpatient (Including Medicare Part A)
611|Intermediate care -Inpatient (Including Medicare Part A) -Admit thru discharge claim|Intermediate care -Inpatient (Including Medicare Part A)
612|Intermediate care -Inpatient (Including Medicare Part A) -Interim first claim|Intermediate care -Inpatient (Including Medicare Part A)
613|Intermediate care -Inpatient (Including Medicare Part A) -Interim continuing claim|Intermediate care -Inpatient (Including Medicare Part A)
614|Intermediate care -Inpatient (Including Medicare Part A) -Interim last claim|Intermediate care -Inpatient (Including Medicare Part A)
615|Intermediate care -Inpatient (Including Medicare Part A) -Late-charge(s)-only claim|Intermediate care -Inpatient (Including Medicare Part A)
616|Intermediate care -Inpatient (Including Medicare Part A) -Reserved (discontinued as of 10/01/00)|Intermediate care -Inpatient (Including Medicare Part A)
617|Intermediate care -Inpatient (Including Medicare Part A) -Replacement of prior claim|Intermediate care -Inpatient (Including Medicare Part A)
618|Intermediate care -Inpatient (Including Medicare Part A) -Void/cancel of prior claim|Intermediate care -Inpatient (Including Medicare Part A)
619|Intermediate care -Inpatient (Including Medicare Part A) -Final claim for a home health PPS episode|Intermediate care -Inpatient (Including Medicare Part A)
620|Intermediate care -Inpatient (Medicare Part B only) -Nonpayment/zero claim|Intermediate care -Inpatient (Medicare Part B only)
621|Intermediate care -Inpatient (Medicare Part B only) -Admit thru discharge claim|Intermediate care -Inpatient (Medicare Part B only)
622|Intermediate care -Inpatient (Medicare Part B only) -Interim first claim|Intermediate care -Inpatient (Medicare Part B only)
623|Intermediate care -Inpatient (Medicare Part B only) -Interim continuing claim|Intermediate care -Inpatient (Medicare Part B only)
624|Intermediate care -Inpatient (Medicare Part B only) -Interim last claim|Intermediate care -Inpatient (Medicare Part B only)
625|Intermediate care -Inpatient (Medicare Part B only) -Late-charge(s)-only claim|Intermediate care -Inpatient (Medicare Part B only)
626|Intermediate care -Inpatient (Medicare Part B only) -Reserved (discontinued as of 10/01/00)|Intermediate care -Inpatient (Medicare Part B only)
627|Intermediate care -Inpatient (Medicare Part B only) -Replacement of prior claim|Intermediate care -Inpatient (Medicare Part B only)
628|Intermediate care -Inpatient (Medicare Part B only) -Void/cancel of prior claim|Intermediate care -Inpatient (Medicare Part B only)
629|Intermediate care -Inpatient (Medicare Part B only) -Final claim for a home health PPS episode|Intermediate care -Inpatient (Medicare Part B only)
630|Intermediate care -Outpatient -Nonpayment/zero claim|Intermediate care -Outpatient
631|Intermediate care -Outpatient -Admit thru discharge claim|Intermediate care -Outpatient
632|Intermediate care -Outpatient -Interim first claim|Intermediate care -Outpatient
633|Intermediate care -Outpatient -Interim continuing claim|Intermediate care -Outpatient
634|Intermediate care -Outpatient -Interim last claim|Intermediate care -Outpatient
635|Intermediate care -Outpatient -Late-charge(s)-only claim|Intermediate care -Outpatient
636|Intermediate care -Outpatient -Reserved (discontinued as of 10/01/00)|Intermediate care -Outpatient
637|Intermediate care -Outpatient -Replacement of prior claim|Intermediate care -Outpatient
638|Intermediate care -Outpatient -Void/cancel of prior claim|Intermediate care -Outpatient
639|Intermediate care -Outpatient -Final claim for a home health PPS episode  640|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Nonpayment/zero claim|Intermediate care -Other
641|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Admit thru discharge claim|Intermediate care -Other
642|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim first claim|Intermediate care -Other
643|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim continuing claim|Intermediate care -Other
644|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Interim last claim|Intermediate care -Other
645|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Late-charge(s)-only claim|Intermediate care -Other
646|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Reserved (discontinued as of 10/01/00)|Intermediate care -Other
647|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Replacement of prior claim|Intermediate care -Other
648|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Void/cancel of prior claim|Intermediate care -Other
649|Intermediate care -Other (for hospital-referenced diagnostic services or home health not under a plan of treatment) -Final claim for a home health PPS episode|Intermediate care -Other
650|NONPAYMENT/ZERO CLAIMS|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
651|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: ADMIT THROUGH DISCHARGE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
652|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: INTERIM FIRST CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
653|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: INTERIM, CONTINUING CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
654|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: INTERIM, FINAL CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
655|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: LATE CHARGE(S) ONLY CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
656|Intermediate care -Intermedicate care Level I -Reserved (discontinued as of 10/01/00)|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
657|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: REPLACEMENT OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
658|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I: VOID/CANCEL OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
659|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65A|ADMISSION/ELECTION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65C|HOSPICE CHANGE OF PROVIDER NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65E|HOSPICE CHANGE OF OWNERSHIP|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65G|CWF INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65H|CMS INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65J|INITIATED ADJUSTMENT CLAIM-OTHER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65K|OIG INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65M|MSP INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65P|QIO ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65Q|Reopening/Adjustment|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
65X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL I
660|NONPAYMENT/ZERO CLAIMS|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
661|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: ADMIT THROUGH DISCHARGE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
662|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: INTERIM FIRST CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
663|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: INTERIM, CONTINUING CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
664|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: INTERIM, FINAL CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
665|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: LATE CHARGE(S) ONLY CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
666|Intermediate care -Intermedicate care Level II -Reserved (discontinued as of 10/01/00)|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
667|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: REPLACEMENT OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
668|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II: VOID/CANCEL OF PRIOR CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
669|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66A|ADMISSION/ELECTION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66C|HOSPICE CHANGE OF PROVIDER NOTICE|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66E|HOSPICE CHANGE OF OWNERSHIP|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66G|CWF INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66H|CMS INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66J|INITIATED ADJUSTMENT CLAIM-OTHER|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66K|OIG INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66M|MSP INITIATED ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66P|QIO ADJUSTMENT CLAIM|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66Q|Reopening/Adjustment|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
66X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II|RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - INTERMEDIATE CARE - LEVEL II
670|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Nonpayment/zero claim|Intermediate care -Subacute inpatient
671|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Admit thru discharge claim|Intermediate care -Subacute inpatient
672|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim first claim|Intermediate care -Subacute inpatient
673|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim continuing claim|Intermediate care -Subacute inpatient
674|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Interim last claim|Intermediate care -Subacute inpatient
675|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Late-charge(s)-only claim|Intermediate care -Subacute inpatient
676|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Reserved (discontinued as of 10/01/00)|Intermediate care -Subacute inpatient
677|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Replacement of prior claim|Intermediate care -Subacute inpatient
678|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Void/cancel of prior claim|Intermediate care -Subacute inpatient
679|Intermediate care -Subacute inpatient (revenue code 019X required when this bill type is used, however 019X may be used with other types of bills) -Final claim for a home health PPS episode|Intermediate care -Subacute inpatient
680|Intermediate care -Swing beds -Nonpayment/zero claim|Intermediate care -Swing beds
681|Intermediate care -Swing beds -Admit thru discharge claim|Intermediate care -Swing beds
682|Intermediate care -Swing beds -Interim first claim|Intermediate care -Swing beds
683|Intermediate care -Swing beds -Interim continuing claim|Intermediate care -Swing beds
684|Intermediate care -Swing beds -Interim last claim|Intermediate care -Swing beds
685|Intermediate care -Swing beds -Late-charge(s)-only claim|Intermediate care -Swing beds
686|Intermediate care -Swing beds -Reserved (discontinued as of 10/01/00|Intermediate care -Swing beds)
687|Intermediate care -Swing beds -Replacement of prior claim|Intermediate care -Swing beds
688|Intermediate care -Swing beds -Void/cancel of prior claim|Intermediate care -Swing beds
689|Intermediate care -Swing beds -Final claim for a home health PPS episode|Intermediate care -Swing beds
690|Intermediate care -Reserved for national assignment -Nonpayment/zero claim|Intermediate care -Reserved for national assignment
691|Intermediate care -Reserved for national assignment -Admit thru discharge claim|Intermediate care -Reserved for national assignment
692|Intermediate care -Reserved for national assignment -Interim first claim|Intermediate care -Reserved for national assignment
693|Intermediate care -Reserved for national assignment -Interim continuing claim|Intermediate care -Reserved for national assignment
694|Intermediate care -Reserved for national assignment -Interim last claim|Intermediate care -Reserved for national assignment
695|Intermediate care -Reserved for national assignment -Late-charge(s)-only claim|Intermediate care -Reserved for national assignment
696|Intermediate care -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Intermediate care -Reserved for national assignment
697|Intermediate care -Reserved for national assignment -Replacement of prior claim|Intermediate care -Reserved for national assignment
698|Intermediate care -Reserved for national assignment -Void/cancel of prior claim|Intermediate care -Reserved for national assignment
699|Intermediate care -Reserved for national assignment -Final claim for a home health PPS episode|Intermediate care -Reserved for national assignment
700|Medicaid Custom Bill Type|Medicaid Custom Bill Type
701|Medicaid Custom Bill Type|Medicaid Custom Bill Type
710|NONPAYMENT/ZERO CLAIMS|CLINIC RURAL HEALTH
711|CLINIC RURAL HEALTH: ADMIT THROUGH DISCHARGE|CLINIC RURAL HEALTH
712|CLINIC RURAL HEALTH: INTERIM, FIRST CLAIM|CLINIC RURAL HEALTH
713|CLINIC RURAL HEALTH: INTERIM, CONTINUING CLAIM|CLINIC RURAL HEALTH
714|CLINIC RURAL HEALTH: INTERIM, FINAL CLAIM|CLINIC RURAL HEALTH
715|CLINIC RURAL HEALTH: LATE CHARGE(S) ONLY CLAIM|CLINIC RURAL HEALTH
716|Clinic -Rural health -Reserved (discontinued as of 10/01/00)|CLINIC RURAL HEALTH
717|CLINIC RURAL HEALTH: REPLACEMENT OF PRIOR CLAIM|CLINIC RURAL HEALTH
718|VOID/CANCEL OF A PRIOR CLAIM|CLINIC RURAL HEALTH
719|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|CLINIC RURAL HEALTH
71A|ADMISSION/ELECTION NOTICE|CLINIC RURAL HEALTH
71B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|CLINIC RURAL HEALTH
71C|HOSPICE CHANGE OF PROVIDER NOTICE|CLINIC RURAL HEALTH
71D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|CLINIC RURAL HEALTH
71E|HOSPICE CHANGE OF OWNERSHIP|CLINIC RURAL HEALTH
71F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|CLINIC RURAL HEALTH
71G|CWF INITIATED ADJUSTMENT CLAIM|CLINIC RURAL HEALTH
71H|CMS INITIATED ADJUSTMENT CLAIM|CLINIC RURAL HEALTH
71I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|CLINIC RURAL HEALTH
71J|INITIATED ADJUSTMENT CLAIM-OTHER|CLINIC RURAL HEALTH
71K|OIG INITIATED ADJUSTMENT CLAIM|CLINIC RURAL HEALTH
71M|MSP INITIATED ADJUSTMENT CLAIM|CLINIC RURAL HEALTH
71P|QIO ADJUSTMENT CLAIM|CLINIC RURAL HEALTH
71Q|Reopening/Adjustment|CLINIC RURAL HEALTH
71X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN CLINIC RURAL HEALTH|CLINIC RURAL HEALTH
720|NONPAYMENT/ZERO CLAIMS|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
721|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: ADMIT THROUGH DISCHARGE|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
722|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: INTERIM, FIRST CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
723|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: INTERIM, CONTINUING CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
724|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: INTERIM, FINAL CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
725|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: LATE CHARGE(S) ONLY CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
726|Clinic -Hospital based or independent renal dialysis center -Reserved (discontinued as of 10/01/00)|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
727|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: REPLACEMENT OF PRIOR CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
728|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: VOID/CANCEL OF PRIOR CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
729|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72A|ADMISSION/ELECTION NOTICE|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72C|HOSPICE CHANGE OF PROVIDER NOTICE|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72E|HOSPICE CHANGE OF OWNERSHIP|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72G|CWF INITIATED ADJUSTMENT CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72H|CMS INITIATED ADJUSTMENT CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72J|INITIATED ADJUSTMENT CLAIM-OTHER|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72K|OIG INITIATED ADJUSTMENT CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72M|MSP INITIATED ADJUSTMENT CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72P|QIO ADJUSTMENT CLAIM|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72Q|Reopening/Adjustment|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
72X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS|HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS
730|NONPAYMENT/ZERO CLAIMS|FEDERALLY QUALIFIED HEALTH CENTERS
731|ADMIT THROUGH DISCHARGE CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
732|INTERIM-FIRST CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
733|INTERIM-CONTINUING CLAIMS (NOT VALID FOR PPS BILLS),FEDERALLY QUALIFIED HEALTH CENTERS|FEDERALLY QUALIFIED HEALTH CENTERS
734|INTERIM-LAST CLAIM (NOT VALID FOR PPS BILLS),FEDERALLY QUALIFIED HEALTH CENTERS|FEDERALLY QUALIFIED HEALTH CENTERS
735|LATE CHARGE ONLY|FEDERALLY QUALIFIED HEALTH CENTERS
736|Clinic -Free-standing -Reserved (discontinued as of 10/01/00)|FEDERALLY QUALIFIED HEALTH CENTERS
737|REPLACEMENT OF PRIOR CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
738|VOID/CANCEL OF A PRIOR CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
739|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|FEDERALLY QUALIFIED HEALTH CENTERS
73A|ADMISSION/ELECTION NOTICE|FEDERALLY QUALIFIED HEALTH CENTERS
73B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|FEDERALLY QUALIFIED HEALTH CENTERS
73C|HOSPICE CHANGE OF PROVIDER NOTICE|FEDERALLY QUALIFIED HEALTH CENTERS
73D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|FEDERALLY QUALIFIED HEALTH CENTERS
73E|HOSPICE CHANGE OF OWNERSHIP|FEDERALLY QUALIFIED HEALTH CENTERS
73F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
73G|CWF INITIATED ADJUSTMENT CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
73H|CMS INITIATED ADJUSTMENT CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
73I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|FEDERALLY QUALIFIED HEALTH CENTERS
73J|INITIATED ADJUSTMENT CLAIM-OTHER|FEDERALLY QUALIFIED HEALTH CENTERS
73K|OIG INITIATED ADJUSTMENT CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
73M|MSP INITIATED ADJUSTMENT CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
73P|QIO ADJUSTMENT CLAIM|FEDERALLY QUALIFIED HEALTH CENTERS
73Q|Reopening/Adjustment|FEDERALLY QUALIFIED HEALTH CENTERS
73X|FREE STANDING CLINIC|FEDERALLY QUALIFIED HEALTH CENTERS
740|NONPAYMENT/ZERO CLAIMS|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
741|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): ADMIT THROUGH DISCHARGE|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
742|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): INTERIM, FIRST CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
743|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): INTERIM, CONTINUING CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
744|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): INTERIM, FINAL CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
745|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): LATE CHARGE(S) ONLY CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): REPLACEMENT OF PRIOR CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
746|Clinic -Outpatient rehabilitation facility (ORF) -Reserved (discontinued as of 10/01/00)|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
747|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): REPLACEMENT OF PRIOR CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
748|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): VOID/CANCEL OF PRIOR CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
749|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74A|ADMISSION/ELECTION NOTICE|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74C|HOSPICE CHANGE OF PROVIDER NOTICE|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74E|HOSPICE CHANGE OF OWNERSHIP|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74G|CWF INITIATED ADJUSTMENT CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74H|CMS INITIATED ADJUSTMENT CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74J|INITIATED ADJUSTMENT CLAIM-OTHER|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74K|OIG INITIATED ADJUSTMENT CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74M|MSP INITIATED ADJUSTMENT CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74P|QIO ADJUSTMENT CLAIM|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74Q|Reopening/Adjustment|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
74X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF)
750|NONPAYMENT/ZERO CLAIMS|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
751|CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): VOID/CANCEL OF PRIOR CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
752|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): INTERIM, FIRST CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
753|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): INTERIM, CONTINUING CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
754|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): INTERIM, FINAL CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
755|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): LATE CHARGE(S) ONLY CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
756|Clinic -Comprehensive outpatient rehabilitation facilities (CORFs) -Reserved (discontinued as of 10/01/00)|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
757|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): REPLACEMENT OF PRIOR CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
758|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): VOID/CANCEL OF PRIOR CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
759|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75A|ADMISSION/ELECTION NOTICE|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75C|HOSPICE CHANGE OF PROVIDER NOTICE|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75E|HOSPICE CHANGE OF OWNERSHIP|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75G|CWF INITIATED ADJUSTMENT CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75H|CMS INITIATED ADJUSTMENT CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75J|INITIATED ADJUSTMENT CLAIM-OTHER|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75K|OIG INITIATED ADJUSTMENT CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75M|MSP INITIATED ADJUSTMENT CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75P|QIO ADJUSTMENT CLAIM|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75Q|Reopening/Adjustment|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
75X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)|CLINIC - COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
760|NONPAYMENT/ZERO CLAIMS|CLINIC - COMMUNITY MENTAL HEALTH CENTER
761|ADMIT THROUGH DISCHARGE CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
762|INTERIM-FIRST CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
763|INTERIM-CONTINUING CLAIMS (NOT VALID FOR PPS BILLS),COMMUNITY MENTAL HEALTH CENTERS|CLINIC - COMMUNITY MENTAL HEALTH CENTER
764|INTERIM-LAST CLAIM (NOT VALID FOR PPS BILLS),COMMUNITY MENTAL HEALTH CENTERS|CLINIC - COMMUNITY MENTAL HEALTH CENTER
765|LATE CHARGE ONLY|CLINIC - COMMUNITY MENTAL HEALTH CENTER
766|Clinic -Community mental health center -Reserved (discontinued as of 10/01/00)|CLINIC - COMMUNITY MENTAL HEALTH CENTER
767|REPLACEMENT OF PRIOR CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
768|VOID/CANCEL OF A PRIOR CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
769|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76A|ADMISSION/ELECTION NOTICE|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76C|HOSPICE CHANGE OF PROVIDER NOTICE|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76E|HOSPICE CHANGE OF OWNERSHIP|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76G|CWF INITIATED ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76H|CMS INITIATED ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76J|INITIATED ADJUSTMENT CLAIM-OTHER|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76K|OIG INITIATED ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76M|MSP INITIATED ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76P|QIO ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76Q|Reopening/Adjustment|CLINIC - COMMUNITY MENTAL HEALTH CENTER
76X|CLINIC - COMMUNITY MENTAL HEALTH CENTER|CLINIC - COMMUNITY MENTAL HEALTH CENTER
770|NONPAYMENT/ZERO CLAIMS|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
771|ORIGINAL CLAIM ADMIT THROUGH DISCHARGE (SAME DAY)|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
772|Clinic -Reserved for national assignment -Interim first claim|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
773|Clinic -Reserved for national assignment -Interim continuing claim|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
774|Clinic -Reserved for national assignment -Interim last claim|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
775|Clinic -Reserved for national assignment -Late-charge(s)-only claim|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
776|Clinic -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
777|ADJUSTMENT OR REPLACEMENT OF PRIOR CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
778|VOID/CANCEL OF A PRIOR CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
779|Clinic -Reserved for national assignment -Final claim for a home health PPS episode|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77A|ADMISSION/ELECTION NOTICE|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77C|HOSPICE CHANGE OF PROVIDER NOTICE|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL||CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77E|HOSPICE CHANGE OF OWNERSHIP|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77G|CWF INITIATED ADJUSTMENT CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77H|CMS INITIATED ADJUSTMENT CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77J|INITIATED ADJUSTMENT CLAIM-OTHER|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77K|OIG INITIATED ADJUSTMENT CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77M|MSP INITIATED ADJUSTMENT CLAIM|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
77P|QIO ADJUSTMENT CLAIM|CLINIC - COMMUNITY MENTAL HEALTH CENTER
77Q|Reopening/Adjustment|CLINIC - COMMUNITY MENTAL HEALTH CENTER
77X|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER|CLINIC - FEDERALLY QUALIFIED HEALTH CENTER
780|Clinic -Reserved for national assignment -Nonpayment/zero claim|Clinic -Reserved for national assignment
781|ACUTE CARE HOSPITAL FACILITY|LICENSED FREE STANDING EMERGENCY MEDICAL FACILITY
782|Clinic -Reserved for national assignment -Interim first claim|Clinic -Reserved for national assignment
783|Clinic -Reserved for national assignment -Interim continuing claim|Clinic -Reserved for national assignment
784|Clinic -Reserved for national assignment -Interim last claim|Clinic -Reserved for national assignment
785|Clinic -Reserved for national assignment -Late-charge(s)-only claim|Clinic -Reserved for national assignment
786|Clinic -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|Clinic -Reserved for national assignment
787|ACUTE CARE HOSPITAL FACILITY|LICENSED FREE STANDING EMERGENCY MEDICAL FACILITY
788|Clinic -Reserved for national assignment -Void/cancel of prior claim|Clinic -Reserved for national assignment
789|Clinic -Reserved for national assignment -Final claim for a home health PPS episode|Clinic -Reserved for national assignment
78X|LICENSED FREE STANDING EMERGENCY MEDICAL FACILITY|LICENSED FREE STANDING EMERGENCY MEDICAL FACILITY
790|Clinic -Other -Nonpayment/zero claim|Clinic -Other
791|Clinic -Other -Admit thru discharge claim|Clinic -Other
792|Clinic -Other -Interim first claim|Clinic -Other
793|Clinic -Other -Interim continuing claim|Clinic -Other
794|Clinic -Other -Interim last claim|Clinic -Other
795|Clinic -Other -Late-charge(s)-only claim|Clinic -Other
796|Clinic -Other -Reserved (discontinued as of 10/01/00)|Clinic -Other
797|Clinic -Other -Replacement of prior claim|Clinic -Other
798|Clinic -Other -Void/cancel of prior claim|Clinic -Other
799|Clinic -Other -Final claim for a home health PPS episode|Clinic -Other
79X|CLINIC - OTHER|CLINIC - OTHER
801|Medicaid Custom Bill Type|Medicaid Custom Bill Type
810|NONPAYMENT/ZERO CLAIMS|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
811|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
812|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): INTERIM, FIRST CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
813|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
814|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): INTERIM, FINAL CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
815|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): LATE CHARGE(S) ONLY|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
816|Special Facility -Hospice (not hospital based) -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
817|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
818|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
819|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81A|ADMISSION/ELECTION NOTICE|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81C|HOSPICE CHANGE OF PROVIDER NOTICE|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81E|HOSPICE CHANGE OF OWNERSHIP|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81G|CWF INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81H|CMS INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81J|INITIATED ADJUSTMENT CLAIM-OTHER|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81K|OIG INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81M|MSP INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81P|QIO ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81Q|Reopening/Adjustment|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
81X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)|SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED)
820|NONPAYMENT/ZERO CLAIMS|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
821|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
822|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): INTERIM, FIRST CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
823|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
824|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): INTERIM, FINAL CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
825|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): LATE CHARGE(S) ONLY|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
826|Special Facility -Hospice (hospital based) -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
827|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
828|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
829|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82A|ADMISSION/ELECTION NOTICE|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82C|HOSPICE CHANGE OF PROVIDER NOTICE|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82E|HOSPICE CHANGE OF OWNERSHIP|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82G|CWF INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82H|CMS INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82J|INITIATED ADJUSTMENT CLAIM-OTHER|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82K|OIG INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82M|MSP INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82P|QIO ADJUSTMENT CLAIM|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82Q|Reopening/Adjustment|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
82X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY HOSPICE (HOSPITAL BASED|SPECIALTY FACILITY HOSPICE (HOSPITAL BASED)
830|NONPAYMENT/ZERO CLAIMS|SPECIALTY FACILITY AMBULATORY SURGERY
831|SPECIALTY FACILITY AMBULATORY SURGERY: ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY AMBULATORY SURGERY
832|SPECIALTY FACILITY AMBULATORY SURGERY: INTERIM, FIRST CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
833|SPECIALTY FACILITY AMBULATORY SURGERY: INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
834|SPECIALTY FACILITY AMBULATORY SURGERY: INTERIM, FINAL CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
835|SPECIALTY FACILITY AMBULATORY SURGERY: LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
836|Special Facility -Ambulatory surgery center -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY AMBULATORY SURGERY
837|SPECIALTY FACILITY AMBULATORY SURGERY: REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
838|SPECIALTY FACILITY AMBULATORY SURGERY: VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
839|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SPECIALTY FACILITY AMBULATORY SURGERY
83A|ADMISSION/ELECTION NOTICE|SPECIALTY FACILITY AMBULATORY SURGERY
83B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SPECIALTY FACILITY AMBULATORY SURGERY
83C|HOSPICE CHANGE OF PROVIDER NOTICE|SPECIALTY FACILITY AMBULATORY SURGERY
83D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SPECIALTY FACILITY AMBULATORY SURGERY
83E|HOSPICE CHANGE OF OWNERSHIP|SPECIALTY FACILITY AMBULATORY SURGERY
83F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
83G|CWF INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
83H|CMS INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
83I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SPECIALTY FACILITY AMBULATORY SURGERY
83J|INITIATED ADJUSTMENT CLAIM-OTHER|SPECIALTY FACILITY AMBULATORY SURGERY
83K|OIG INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
83M|MSP INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
83P|QIO ADJUSTMENT CLAIM|SPECIALTY FACILITY AMBULATORY SURGERY
83Q|Reopening/Adjustment|SPECIALTY FACILITY AMBULATORY SURGERY
83X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY AMBULATORY SURGERY|SPECIALTY FACILITY AMBULATORY SURGERY
840|NONPAYMENT/ZERO CLAIMS|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
841|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
842|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: INTERIM, FIRST CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
843|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
844|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: INTERIM, FINAL CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
845|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
846|Special Facility -Free-standing birthing center -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
847|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
848|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER: VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
849|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84A|ADMISSION/ELECTION NOTICE|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84C|HOSPICE CHANGE OF PROVIDER NOTICE|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84E|HOSPICE CHANGE OF OWNERSHIP|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84G|CWF INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84H|CMS INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84J|INITIATED ADJUSTMENT CLAIM-OTHER|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84K|OIG INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84M|MSP INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84P|QIO ADJUSTMENT CLAIM|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84Q|Reopening/Adjustment|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
84X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER|SPECIALTY FACILITY - FREE STANDING BIRTHING CENTER - RECLASSIFIED TO OUTPATIENT ONLY
850|NONPAYMENT/ZERO CLAIMS|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
851|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL: ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
852|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL: INTERIM, FIRST CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
853|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL: INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
854|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL: INTERIM, FINAL CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
855|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL: LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
856|Special Facility -Critical access hospital -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
857|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL: REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
858|VOID/CANCEL OF A PRIOR CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
859|FINAL CLAIM FOR A HOME HEALTH PPS EPISODE|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85A|ADMISSION/ELECTION NOTICE|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85B|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION. TERMINATION/REVOCATION NOTICE|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85C|HOSPICE CHANGE OF PROVIDER NOTICE|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85D|HOSPICE/MEDICARE COORDINATED CARE DEMONSTRATION/RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTION VOID/CANCEL|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85E|HOSPICE CHANGE OF OWNERSHIP|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85F|BENEFICIARY INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85G|CWF INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85H|CMS INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85I|FI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85J|INITIATED ADJUSTMENT CLAIM-OTHER|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85K|OIG INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85M|MSP INITIATED ADJUSTMENT CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85P|QIO ADJUSTMENT CLAIM|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85Q|Reopening/Adjustment|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
85X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL|SPECIALTY FACILITY - CRITICAL ACCESS HOSPITAL
860|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - NON-PAYMENT/ZERO CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
861|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
862|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, FIRST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
863|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
864|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, LAST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
865|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
866|Special Facility -Residential facility -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
867|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
868|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
869|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - RESERVED FOR NATIONAL ASSIGNMENT|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
86X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY - RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE|SPECIALTY FACILITY - RESIDENTIAL FACILITY
870|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - NON-PAYMENT/ZERO CLAIM|SPECIALTY FACILITY - RESIDENTIAL FACILITY
871|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
872|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, FIRST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
873|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
874|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, LAST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
875|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
876|Special Facility -Reserved for national assignment  -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
877|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
878|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
879|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - RESERVED FOR NATIONAL ASSIGNMENT|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
87X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY  G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
880|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - NON-PAYMENT/ZERO CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
881|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
882|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, FIRST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
883|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
884|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - INTERIM, LAST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
885|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
886|Special Facility -Reserved for national assignment -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
887|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
888|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
889|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE - RESERVED FOR NATIONAL ASSIGNMENT|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
88X|OTHER NON-SIGNIFICANT PROCEDURES PERFORMED IN SPECIALTY FACILITY  G?? RESIDENTIAL FACILITY - RESERVED FOR NATIONAL USE|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
890|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - NON-PAYMENT/ZERO CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
891|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - ADMIT THROUGH DISCHARGE|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
892|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - INTERIM, FIRST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
893|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - INTERIM, CONTINUING CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
894|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - INTERIM, LAST CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
895|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - LATE CHARGE(S) ONLY CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
896|Special Facility -Other -Reserved (discontinued as of 10/01/00)|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
897|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - REPLACEMENT OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
898|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - VOID/CANCEL OF PRIOR CLAIM|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
899|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY - OTHER - RESERVED FOR NATIONAL ASSIGNMENT|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
89X|SPECIALTY FACILITY - OTHER|SPECIALTY FACILITY G?? RESIDENTIAL FACILITY
921|Medicaid Custom Bill Type|Medicaid Custom Bill Type
931|Medicaid Custom Bill Type|Medicaid Custom Bill Type
968|Medicaid Custom Bill Type|Medicaid Custom Bill Type
999|Medicaid Custom Bill Type|Medicaid Custom Bill Type
J13|Medicaid Custom Bill Type|Medicaid Custom Bill Type
M31|Medicaid Custom Bill Type|Medicaid Custom Bill Type
MXA|Medicaid Custom Bill Type|Medicaid Custom Bill Type
N18|Medicaid Custom Bill Type|Medicaid Custom Bill Type
X31|Medicaid Custom Bill Type|Medicaid Custom Bill Type
