UB04 Box 4 - Type of Bill on an institutional claim

On an institutional claim, a 4-digit code in box 4 identifies the type of facility and type of care, and the frequency code is generated based on parameters set under the office settings and attached to a patient's claim.

Facility Level

• To set the information for the facility, navigate to Account > Office > Edit > Billing > Institutional Billing.

• • Information that claims/visits specific can be entered on the appointment level. The options are available to set at a facility level to increase efficiency. Any information loaded at the claim level will override what is entered at a facility level.

• • First digit - Leading zero that is ignored by some payers
• • Second digit - Type of Facility
    • 1- Hospital
    • 2- Skilled Nursing Facility
    • 3- Home Health
    • 4- Christian Science (Hospital)
    • 5- Christian Science (Extended Care)
    • 6- Intermediate Care
    • 7- Clinic
    • 8- Special Facility
• • Third digit - Type of Care
    • 1- Including Medicare Part A
    • 2- Medicare Part B Only
    • 3- Outpatient
    • 4- Other
    • 5- Intermediate Care - Level I
    • 6- Intermediate Care - Level II
    • 7- Intermediate Care - Level III
    • 8- Swing Bed
• • Fourth digit - Sequence of this bill in the sequence of care (aka frequency code)
    • 0- Non-Payment/Zero Claim
    • 1- Admit Through Discharge Date
    • 2- First Interim Claim
    • 3- Continuing Interim Claim
    • 4- Last Interim Claim
    • 5- Late Charge(s) Only Claim
    • 6- First Interim Claim
    • 7- Replacement of Prior Claim
    • 8- Void/Cancel of Prior Claim

Appointment/Claim Level

• To set the information on the claim level, navigate to Billing > Live Claims Feed > Inside patient's appointment > Right side of the screen > Info tab

• • Please note any information loaded/included at the appointment level will override what has been entered for the facility under Account > Offices

• • Each drop-down will show available selections. The number that prints in box 4 on the UB04 form will populate based on the information added.