Back to top
Short SAS Name
FREQ_CD
SAS Name
CLM_FREQ_CD

The third digit of the type of bill (TOB3) submitted on an institutional claim record to indicate the sequence of a claim in the beneficiary's current episode of care. 

Comments

This field can be used in determining the "type of bill" for an institutional claim. Often type of bill consists of a combination of two variables: the facility type code (variable called CLM_FAC_TYPE_CD) and the service classification type code (CLM_SRVC_CLSFCTN_TYPE_CD). This variable serves as the optional third component of bill type, and it is helpful for distinguishing between final, interim, or RAP (request for anticipated payment) claims - which is particularly helpful if you receive claims that are not "final action".

Many different types of services can be billed on a Part A or Part B institutional claim, and knowing the type of bill helps to distinguish them. The type of bill is the concatenation of three variables : the facility type (CLM_FAC_TYPE_CD), the service classification type code (CLM_SRVC_CLSFCTN_TYPE_CD), and the claim frequency code (CLM_FREQ_CD).

Source: NCH

CodeCode value
0
Non-payment/zero claims
1
Admit thru discharge claim
2
Interim - first claim
3
Interim - continuing claim
4
Interim - last claim
5
Late charge(s) only claim
7
Replacement of prior claim
8
Void/cancel prior claim
9
Final claim (for HH PPS = process as a debt/credit to RAP claim)
G
Common Working File (NCH) generated adjustment claim
H
CMS generated adjustment claim
I
Misc adjustment claim (e.g., initiated by intermediary or QIO)
J
Other adjustment request
M
Medicare secondary payer (MSP) adjustment
P
Adjustment required by QIO