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Correction: Claim submission requirements when billing with place of service code 22

April 1, 2015

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This article contains corrections to the field requirements for electronically submitted claims that appeared in the March 2015 edition of Partners in Health Update℠. This article was also designated for both professional and facility provider types; however, it was intended for professional and ancillary providers. We apologize for any confusion this may have caused.

When billing with place of service code 22, outpatient hospital, it is important to remember that you must complete all required fields in their entirety, specifically as it relates to the Servicing Facility field. It is important that the proper ZIP code is included to receive accurate payment.

Required fields


For claims submitted electronically:

  • Loop 2310C NM1 (Service Facility Location Name)
        N3 (Service Facility Location Address)
        N4 (Service Facility Location City, State, ZIP Code)
        REF (Service Facility Location Secondary Identification)
For claims submitted on paper:
  • Box 32 (see image, right)

CMS1500

Completing all required fields facilitates the submission of a Clean Claim as contractually required.

For complete information on submitting claims electronically, refer to the EDI section of our website. For complete information on submitting paper claims, please read the Claims Submission Toolkit for Proper Electronic and Paper Claims Submission.

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