Type of Service Code for Claims Submission for Medical Provider Services

Type of Service Code for Claims Submission for Medical Provider Services

 

Type of Service Code for Claims Submission for Medical Provider Services

Type of Service Code for Claims Submission for Medical Provider Services

1 = Medical Care
Medical services to diagnose and/or treat a medical condition, illness, or injury

2 = Surgical
Surgical services provided by a healthcare provider

3 = Consultation
Counseling and/or coordination of care with other Physicians, other qualified Healthcare Providers or agencies

4 = Diagnostic X-Ray
Diagnostic x-ray provided by a healthcare provider

5 Diagnostic Lab
Diagnostic lab provided by a healthcare provider

6 Radiation Therapy
Radiation therapy provided by a healthcare provider

7 = Anesthesia
Anesthesia services provided by a healthcare provider

8 Surgical Assistance
Assistant surgeon/surgical assistance provided by a healthcare provider if required because of the complexity of the surgical procedures

10 Blood
The allotment of whole blood, blood plasma, or blood derivatives

11 Durable Medical Equipment Used
Used equipment needed for medical reasons to be used by a person that is ill or injured and is ordered by a health care provider for use in the home.

12 Durable Medical Equipment Purchased
Purchased equipment needed for medical reasons to be used by a person that is ill or injured and is ordered by a healthcare provider for use in the home.

14 Renal Supplies
Supplies to support treatment of kidneys, or bladder functions. (Example: Dialysis Supplies and/or catheters)

17 Pre-Admission Testing
Services related to the preparation for admission to establish the patients current health status.

18 Durable Medical Equipment Rental
Rental equipment needed for medical reasons to be used by a person that is ill or injured and is ordered by a healthcare provider for use in the home.

19 Pneumonia Vaccine
Services provided by a physician or other healthcare provider related to administration of Pneumococcal Pneumonia vaccination.

20 Second Surgical Opinion
Second professional opinion sought to verify or confirm the necessity for surgical procedures

21 Third Surgical Opinion
Third professional opinion sought to verify or confirm the necessity for surgical procedures

22 Social Work
Services related to a systematic way of helping individuals and groups towards better adaptation to society

23 Diagnostic Dental
The translation of data gathered by clinical and radiographic examination into an organized, classified definition of conditions present.

24 Periodontics
The art and science of examination, diagnosis, and treatment of diseases affecting the periodontium; a study of the supporting structures of the teeth, normal anatomy and physiology and the deviations.

25 Restorative
Broad term applied to any restorations to the tooth/teeth structure(s). Anterior teeth include up to five surface classifications – Mesial, Distal, Incisal, Lingual and Labial. Posterior teeth include up to five surface classifications: Mesial, Distal, Occlusal, Lingual and Buccal.

26 Endodontics
The branch of dentistry that is concerned with the morphology, physiology and pathology of the dental pulp and periradicular (gum) tissues.

27 Maxillofacial Prosthetics
The branch of prosthetics is concerned with the restoration of stomatognathic and associated facial structure that have been affected by disease, injury, surgery, or congenital defect.

28 Adjunctive Dental Services
Typically these services involve a drug such as anesthesia or other substances that serve as a supplemental purpose in dental therapy.

30 Health Benefit Plan Coverage
General healthcare benefits for the member’s policy or contract

32 Plan Waiting Period

33 Chiropractic
Manipulations and modalities provided by a healthcare provider

35 Dental Care
The treatment of the teeth and their supporting structures.

36 Dental Crowns
An artificial replacement for the natural crown of the tooth covering all five surfaces (Anterior teeth surface classifications – Mesial, Distal, Incisal, Lingual and Labial. Posterior teeth surface classifications: Mesial, Distal, Occlusal, Lingual and Buccal.

37 Dental Accident
Supplies or appliances for care of teeth due to accidental injury provided by healthcare provider

38 Orthodontics
The area of dentistry concerned with the supervision, guidance, and correction of the growing and mature orofacial structures. This includes conditions that require movement of the teeth or correction of the malrelationships and malformations of related structures by the adjustment of relationships between and among teeth and facial bones by the application of forces or the stimulation and redirection of functional forces within the craniofacial complex.

39 Prosthodontics
The part of dentistry pertaining to the restoration and maintenance of oral function, comfort, appearance and health of the patient by replacement of missing teeth and contiguous tissues with artificial substitutes. It has three main branches: removable prosthodontics, fixed prosthodontics and maxillofacial prosthetics.

40 Oral Surgery
Diagnosis and treatment of disorders of the mouth, teeth, jaws and facial structure provided by a healthcare provider

41 Preventive Dental
The dental procedures in dental practice and health programs that prevent the occurrence of oral diseases.

42 Home Health Care
Healthcare services rendered in the home by a healthcare provider

43 Home Health Prescriptions

45 Hospice
An integrated set of services and supplies to provide palliative and supportive care to terminally ill patients.

46 Respite Care
Services related to temporary care of a dependent elderly, ill, or handicapped person, providing relief for their usual caregivers

47 Hospitalization
Hospital Inpatient and Outpatient services and supplies for a patient who may or may not have been admitted to a hospital, for the purpose of receiving medical care or other health services.

49 Hospital – Room and Board

54 Long Term Care
Care provided for an individual when they cannot care for themselves within the home or in a facility

55 Major Medical

56 Medically Related Transportation
Ambulance, Ambulate or other Medical transport services

60 General Benefits
Indicates whether a patient has active or inactive medical coverage for the service date requested.

61 In-vitro Fertilization
Services to treat infertility

62 MRI Scan
Diagnostic MRI (Magnetic Resonance Imaging) services.

63 Donor Procedures
Services related to the collection of tissues, organs, or fluids for use in the treatment for another person

64 Acupuncture
A system of alternative treatment that involves pricking the skin or tissues with needles

65 Newborn Care
Management of the infant during the transition to extra uterine life and subsequent period of stabilization

66 Pathology
Creation of slides from tissues and its interpretation provided by a healthcare provider

67 Smoking Cessation
Treatment to assist in the discontinuation of the use of nicotine

68 Well Baby Care
Medical services and physician visits which are recommended by the American Pediatric Association as appropriate and routine care for a child to a specific age limit.

69 Maternity
Services related to maternity care including related conditions resulting in childbirth when provided, or ordered and billed by a physician or nurse midwife

70 Transplants
Services related to the transfer of living organs or tissue from one body to another.

71 Audiology
Services related to hearing disorders, including evaluation of hearing function and rehabilitation of patients with hearing impairment

72 Inhalation Therapy
Services related to the use of inhaled agents to treat respiratory diseases and conditions

73 Diagnostic Medical
Services required to determine the diagnose to treat a medical condition, illness, or injury

74 Private Duty Nursing
A nurse who is hired to provide focused care to an individual patient in a hospital, clinic, nursing home or patient’s home

75 Prosthetics
A device that is used to replace a part of the body that is missing.

76 Dialysis
The process by which uric acid and urea are removed from circulating blood by means of a dialyzer

77 Otology
Services related to diagnosis and treatment of the ear and related structures

78 Chemotherapy
The treatment of disease by means of chemicals that have a specific toxic effect upon the disease-producing microorganisms or that selectively destroy cancerous tissue.

Keyword: Type of Service Code for Claims Submission for Medical Provider Services

79 Allergy Testing
A skin or blood test to determine what substance, or allergen, may trigger an allergic response in a person

80 Immunizations
The introduction of a vaccine with the goal of producing immunity

81 Routine Physical
A physical examination performed on asymptomatic patients for medical screening purposes.

82 Family Planning
Educational services that assists individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility.

83 Infertility
Services to diagnose and/or treat infertility. Covered services may include assisted reproductive technology procedures.

84 = Abortion
Services related to the elective termination of a pregnancy

85 HIV – AIDS Treatment
Services related to diagnosis and treatment of HIV – AIDS

86 = Emergency Services
Services provided by healthcare providers for the treatment of a sudden and unexpected medical condition or injury which requires immediate medical attention

87 Cancer Treatment
Services related to diagnosis and treatment of cancer not performed by an Oncologist

88 Retail/Independent Pharmacy
A licensed entity that dispenses prescription drugs and provides professional pharmacy services, such as clinical pharmacy consulting respective to the dispensing function. The entity may be a retail/chain or independent pharmacy or any other entity which dispenses prescription drugs.

89 Free Standing Prescription Drug
Members have separate cost sharing for prescription drugs and medical coverage.

90 Mail Order Pharmacy
A mail order pharmacy delivers medications directly to patients through the mail.

91 Brand Name Prescription Drug
The original formulation of a prescription drug, approved by the FDA for distribution.

92 Generic Prescription Drug
Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts.

Keyword: Type of Service Code for Claims Submission for Medical Provider Services

93 = Podiatry
Professional services of a physician or other healthcare provider for the care or treatment of conditions of the foot.

A4 Psychiatric
Services related to the diagnosis or treatment of mental health.

A6 Psychotherapy
Professional services, including individual or group therapy by providers such as psychiatrists, psychologists, clinical social workers, or psychiatric nurses.

A7 Psychiatric – Inpatient

A8 Psychiatric – Outpatient

A9 Rehabilitation
Services related to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible

AB Rehabilitation – Inpatient

AC Rehabilitation – Outpatient

AD Occupational Therapy
Professional and facility occupational therapy services performed by an occupational therapist, physician or other healthcare provider at a hospital, office or other covered facility.

AE Physical Medicine
Services related to the diagnosis, evaluation, and management of persons of all ages with physical and/or cognitive impairment and disability.

AF Speech Therapy
Professional and facility speech therapy services performed by a speech therapist, physician or other healthcare provider at a hospital, office or other covered facility.

AG Skilled Nursing Care
Services for a patient in a skilled nursing facility for the purpose of receiving medical care or other health services.

AI Substance Abuse
Services provided at a hospital, office or other covered facility as they are related to the diagnosis and treatment of Substance Abuse.

AJ Alcoholism Treatment
Services related to the management of Alcohol dependencies or addiction

AK Drug Addiction
Services related to the management of Drug dependencies or addiction, excluding Alcohol

AL Optometry
Routine vision services furnished by an optometrist. May include coverage for eyeglasses, contact lenses, routine eye exams, and/or vision testing for the prescribing or fitting of eyeglasses or contact lenses.

AM Frames
The framework for a pair of eyeglasses

AO Lenses
A piece of transparent substance having two opposite surfaces either both curved or one curved and one plane, used in an optical device in correcting defects of vision.

AP Routine Eye Exam
A series of tests to evaluate an individual’s vision and check for eye diseases.

AQ Nonmedically Necessary Physical (These physicals are required by other entities e.g., insurance application, pilot license, employment or school)
A physical examination performed on asymptomatic patients for medical screening purposes.

AR Experimental Drug Therapy
Treatment of a physical or mental condition using non-generally accepted drugs, such as not FDA approved, Clinical Trial.

B1 Burn Care
Services related to the treatment of Burns

B2 Brand Name Prescription Drug – Formulary
Lists of brand name drugs covered and published by the health plan/payer/processor/PBM to help physicians reach clinically and economically appropriate prescribing decisions for patients.

B3 Brand Name Prescription Drug – Non-Formulary
A brand name drug that is not listed on the covered and published list of the health plan/payer/processor/PBM.

BA Independent Medical Evaluation
Services when a doctor/physical therapist/chiropractor/psychologist/neuropsychologist who has not previously been involved in a person’s care examines an individual. There is no doctor/therapist-patient relationship.

BB Psychiatric Treatment Partial Hospitalization
A step-down transition from acute inpatient care or an alternative to inpatient treatment for the practice or science of diagnosing and treating mental disorders.

BC Day Care (Psychiatric)
A step-down transition from acute inpatient care or an alternative to inpatient treatment for the practice or science of diagnosing and treating mental disorders.

BD Cognitive Therapy
A type of psychotherapy in which negative patterns of thought, are challenged in order to alter unwanted behavior patterns or treat mood disorders.

BE Massage Therapy
The manipulation of muscles and other soft tissues of the body by a therapist for the treatment of health conditions such as pain, cancer, fibromyalgia, HIV/AIDS, depression.

BF Pulmonary Rehabilitation
Services and instructional guidance administered to an individual suffering from respiratory disease in an attempt to improve the quality of life for the patient.

BG Cardiac Rehabilitation
Services and instructional guidance rendered by a physician or other healthcare provider in a hospital or covered facility that are designed to help an individual recover from a cardiovascular event

BH Pediatric
Treatment or care related to infants, children, and adolescents

BI Nursery Room and Board
Treatment or care related to newborns

BK Orthopedic
Services related to the correction or prevention of deformities, disorders, or injuries of the skeleton and associated structures.

BL Cardiac
Services of or relating to the heart

BM Lymphatic
Services related to a lymph, lymph node, or a lymphatic vessel

BN Gastrointestinal
Services to treat disorders of the stomach and intestines, and related systems

BP Endocrine
Services related to the systems that secrete hormones

BQ Neurology
Services related to the treatment of the nerves or nervous system.

BT Gynecological
Medical care and management of the female reproductive system and associated disorders provided by a physician or other healthcare provider.

BU Obstetrical
Medical care and management related to the care of a woman prior, during and after pregnancy, provided by a physician or other healthcare provider.

BV Obstetrical/Gynecological

BY Physician Visit – Sick
Professional services rendered by a physician or other healthcare provider during a non-routine visit related to a illness.

BZ Physician Visit – Well
Professional services rendered by a physician or other healthcare provider during a routine or preventative care visit.

C1 Coronary Care
Treatment of diseases of the arteries of the heart

CK Screening X-ray
X-ray services provided by a physician or other healthcare provider for the purpose of preventative care.

CL Screening laboratory
Laboratory services provided by a physician or other healthcare provider for the purpose of preventative care.

CM Mammogram, High Risk Patient
Mammography services for patients that have been identified with a greater than normal risk for breast cancers and related diseases.

CN Mammogram, Low Risk Patient
Mammography services for patients that have been identified with a normal risk for breast cancers and related diseases.

CO Flu Vaccination
Services provided by a physician or other healthcare provider related to the administration of influenza virus vaccination.

CP Eyewear Accessories
Services related to Eyewear and Eyewear Accessories

CQ Case Management
Services that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client’s health and human service needs

DG Dermatology
Services provided by a physician or other healthcare provider involving the skin and its diseases.

DM Durable Medical Equipment
Durable medical equipment that can withstand repeated use and is primarily and customarily used to serve a medical purpose and generally is not useful to a person in the absence of an illness or injury.

DS Diabetic Supplies
Blood sugar (glucose) test strips, monitors, insulin, lancet devices and lancets, glucose control solutions used to monitor and assist in the treatment of diabetes.

E0 Applied Behavioral Analysis Therapy
Services related to the assessment and treatment of learning and/or developmental disabilities to include techniques and principles to bring about meaningful and positive changes in behavior, improve attention, focus, memory, academics and/or increase language, communication and social skills.

E1 Non-Medical Equipment (non DME)
Durable equipment that can withstand repeated use and serves to augment or replace impaired functionality, environmental control and facilitate a patient’s independent living.

E2 Psychiatric Emergency
Emergency services related to the diagnosis or treatment of mental disease.

E3 Step Down Unit
A hospital unit providing a level of care between intensive and routine.

E4 Skilled Nursing Facility Head Level of Care
Services directly related to care associated with severe brain injuries requiring a skilled level of care.

E5 Skilled Nursing Facility Ventilator Level of Care
Services directly related to care associated with ventilator dependent respiratory conditions requiring a skilled level of care.

E6 Level of Care 1
Skilled Care – Skilled Nursing Care in a regular hospital bed

E7 Level of Care 2
Comprehensive Care – Skilled Nursing Care Level II includes attributes of prior level plus services such as Wound Care (Stage 3), Tracheotomy Care, etc.

E8 Level of Care 3
Complex Care – Skilled Nursing Care Level III include attributes of prior levels plus services such as Ventilator Care, Specialty Beds, Peritoneal Dialysis, etc.

E9 Level of Care 4

E10 Radiographs
An image or picture produced on a radiation-sensitive film emulsion by exposure to ionizing radiation direct through an area, region, or substance of interest, followed by chemical processing of the film

E11 Diagnostic Imaging
The use of radiographic, sonographic, and other technologies to create a graphic depiction of the body parts in question.

E14 Fixed Prosthodontics
The branch of prosthodontics concerned with the replacement or restoration of teeth by artificial substitutes that are not readily removable such as fixed partial dentures, pontics and abutments.

E15 Removable Prosthodontics
The branch of prosthodontics concerned with the replacement or restoration of teeth by artificial substitutes that are readily removable such as a denture, partial denture and interim prosthesis.

E16 Intraoral Images – Complete Series
Complete set of images using radiographic, sonographic, and other technologies representing an image or set of images within the oral cavity.

E17 Oral Evaluation
The art and science of evaluation to make a clinical judgment or appraisal of a patient’s dental health or condition.

E18 Dental Prophylaxis
A series of procedures where plaque, calculus, and stain are removed from the teeth often referred to as “prophy” or teeth cleaning.

E19 Panoramic Images
A tomogram of the jaws, taken with a specialized machine designed to present a panoramic view of the full circumferential length of the jaws on a single film.

E20 Sealants
A resinous material designed for application to the occlusal surfaces of posterior teeth to seal the surface irregularities and prevent the carious process.

E21 Fluoride Treatments
A separate process from dental prophylaxis of applying prescription strength fluoride product designed to prevent caries.

E22 Dental Implants
A device, usually alloplastic, that is surgically inserted into or onto the oral tissue. To be used as a prosthodontic abutment, it should remain quiescent and purely secondary to local tissue physiology.

E23 Temporomandibular Joint Dysfunction
Services related to the Impaired function of the temporomandibular articulation of the jaw.

E24 Retail Pharmacy Prescription Drug
Dispenses prescription drugs and provides professional pharmacy services, such as clinical pharmacy consulting respective to the dispensing function. The entity may be a retail/chain or independent pharmacy or any other entity which dispenses prescription drugs.

E25 Long Term Care Pharmacy
Long term care pharmacy serve the residents of nursing homes, assisted care facilities, extended care facilities, retirement homes, or post acute care. These are considered “closed door pharmacies”

E26 Comprehensive Medication Therapy Management Review
A holistic review of medical care provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients

E27 Targeted Medication Therapy Management Review
A targeted medication therapy management (MTM) review is consultation with a patient about their medication therapy related to a specific diagnosis, disease state or medication

E28 Dietary/Nutritional Services
Nutrition and diet counseling such as: weight management, eating disorders, pregnancy, pediatric, food allergy, diabetes, celiac disease

E33 Intensive Cardiac Rehabilitation
A group of physical activities designed to help a patient recover from a cardiovascular event

E36 Convenience Care
A category of walk-in clinic located in retail stores, supermarkets and pharmacies that treat uncomplicated minor illnesses

Type of Service Code for Claims Submission for Medical Provider Services

E37 Telemedicine
Services provided via telecommunication and/or information technology venues to provide clinical health services.

Notes: Services performed that are related to telemedicine; not a place of service.
E38 Pharmacist Services
Clinical services provided by a pharmacist

E39 Diabetic Education
Patient educational program designed to bring awareness of diabetes, what it takes to treat it, and the necessary changes that should be made to improve their lifestyle.

E40 Early Intervention
Services related to treatment for babies or toddlers with developmental delays or disabilities.

EA Preventive Services
Preventive services such as check-ups, patient counseling and screenings to prevent illness, disease and other health-related problems.

EB Specialty Pharmacy
Specialty pharmacies are designed to efficiently deliver medications with specialized handling, storage, and distribution requirements. Specialty pharmacies are also designed to improve clinical and economic outcomes for patients with complex, often chronic and rare conditions, with close contact and management by clinicians.

EC Durable Medical Equipment New
New equipment needed for medical reasons to be used by a person that is ill or injured and is ordered by a health care provider for use in the home.

ED CAT Scan
A multi-dimensional diagnostic image of a cross section of the body that is useful in diagnosing disease

EE Ophthalmology
Services related to diagnosis and treatment of the eye and related structures including surgical services.

EF Contact Lenses
A thin lens placed directly on the surface of the eye. Contact Lenses are considered medical devices

F1 Medical Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F2 Social Work Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F3 Dental Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F4 Hearing Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F5 Prescription Drug Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F6 Vision Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F7 Orthodontia Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

F8 Mental Health Coverage
This code will be used by the payer on the 271 response to show coverage type. This code cannot be submitted with the 270 Inquiry.

GF Generic Prescription Drug – Formulary
Lists of generic drugs covered and published by the health plan/payer/processor/PBM to help physicians reach clinically and economically appropriate prescribing decisions for patients.

GN Generic Prescription Drug – Non-Formulary
A generic drug that is not listed on the covered and published list of the health plan/payer/processor/PBM.

GY Allergy
Services for conditions caused by abnormal hypersensitivity of the immune system to medications, chemical or food substances, and/or environmental factors.

IC Intensive Care
Continuous and closely monitored health care services provided in a hospital to critically ill patients.

MH Mental Health
Mental Health services provided by a physician or other healthcare providers who are trained and educated to perform services related to mental health and may be licensed or practice within the scope or licensure or training.

NI Neonatal Intensive Care
Continuous and closely monitored health care services provided in a hospital to critically ill newborn/neonatal patients.

ON Oncology
Services related to diagnosis and treatment of cancer provided by an Oncology provider

PE Positron Emission Tomography (PET) Scan
A nuclear imaging examination which reveals molecular function and activity.

PT Physical Therapy
Services and care related to evaluation and treatment of injury or disorders

PU Pulmonary
Services related to the diagnosis and treatment of respiratory conditions.

RN Renal
Services related to the diagnosis and treatment of kidney conditions.

RT Residential Psychiatric Treatment
Psychiatry services provided at a live-in facility to a person with emotional disorders who requires continuous medication and/or supervision or relief from environmental stresses

SMH Serious Mental Health
Services for disorders characterized by severe deficits and pervasive impairment in multiple areas of development.
Start: 01/30/2011
TC Transitional Care
Services related to the coordination and continuity of heath care during a movement from one health care setting to another or to home.

TN Transitional Nursery Care
Services related to the coordination and continuity of heath care for a newborn during a movement from one health care setting to another or to home.

UC Urgent Care
Medical services and supplies provided by physicians or other healthcare providers for the treatment of an urgent medical condition or injury which requires medical attention.

 

 

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