What are the Billing and Coding Requirements?
• For inpatient services, use Bill type 11X • For all outpatient services including services approved as Ambulatory Surgery Center (ASC) services, use Bill type 85X • For ancillary/ambulance services, use Bill type 12X • For non-patient diagnostic service, use Bill type 14X • For swing bed services, use Bill type 18X • Ambulance services furnished by CAHs that are exempt from the allowable charge methodology will be paid under the Reasonable Cost Method if the B2 condition code is entered on the claim. B2 must be reported within the first five condition code fields in order to pay at the Reasonable Cost Method.
