Use Claim Filing Indicator Code

Claim Filing Indicator Code O 1 ID 1/2
Code identifying type of claim

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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