Use Claim Filing Indicator Code
Claim Filing Indicator Code O 1 ID 1/2
Code identifying type of claim
314 SITUATIONAL RULE
Required prior to mandated use of the HIPAA National Plan ID. If not required by this implementation guide, do not send.
CODE DEFINITION
11 – Other Non-Federal Programs
12 – Preferred Provider Organization (PPO)
13 – Point of Service (POS)
14 – Exclusive Provider Organization (EPO)
15 – Indemnity Insurance
16 – Health Maintenance Organization (HMO) Medicare Risk
17 – Dental Maintenance Organization
AM – Automobile Medical
BL – Blue Cross/Blue Shield
CH – Champus
CI – Commercial Insurance Co.
DS – Disability
FI – Federal Employees Program
HM – Health Maintenance Organization
LM – Liability Medical
MA – Medicare Part A
MB – Medicare Part B
MC – Medicaid
OF – Other Federal Program
1484 – Use code OF when submitting Medicare Part D claims.
TV – Title V
VA – Veterans Affairs Plan
WC – Workers’ Compensation Health Claim
ZZ – Mutually Defined
71 – Use Code ZZ when Type of Insurance is not known
Updated 7 months ago