bill type code
bill_typ_cdDefinition
ISO-11179 Definition
A three-digit code on institutional claims that identifies the type of facility, the type of care provided, and the sequence of the claim in a series of bills for a continuous course of treatment. Bill type codes appear in Form Locator 4 of the UB-04 claim form and are required for all institutional claims to Medicare, Medicaid, and most commercial payers. The first digit identifies the type of facility such as 1 for hospital, 2 for skilled nursing facility, 3 for home health, and 7 for clinic.
The second digit identifies the type of care such as 1 for inpatient including Medicare Part A, 3 for outpatient, and 4 for other outpatient including home health. The third digit indicates the claim sequence such as 1 for admit through discharge, 2 for interim first claim, 3 for interim continuing claim, and 4 for interim last claim. Healthcare data teams use bill_typ_cd in claims analytics to segment institutional claims by facility type and care setting, validate bill type appropriateness for the billed services, and identify billing pattern anomalies.
Standard Abbreviation
bill_typ_cd
Category
Production DDL — FACT_CLAIM_TRANSACTION
CREATE OR REPLACE TABLE FACT_CLAIM_TRANSACTION (
clm_txn_key INTEGER NOT NULL -- surrogate key,
clm_id VARCHAR(50) NOT NULL -- claim identifier,
mbr_key INTEGER NOT NULL -- FK to DIM_MEMBER,
prvdr_key INTEGER NOT NULL -- FK to DIM_PROVIDER,
clm_typ_cd VARCHAR(10) -- claim type code,
tot_chrg_amt DECIMAL(18,2) -- total charged amount,
tot_alwd_amt DECIMAL(18,2) -- total allowed amount,
tot_pd_amt DECIMAL(18,2) -- total paid amount,
cntrct_adj_amt DECIMAL(18,2) -- contractual adjustment,
denial_ind CHAR(1) -- denial indicator,
denial_rsn_cd VARCHAR(10) -- denial reason code,
prior_auth_nbr VARCHAR(30) -- authorization number,
clm_lag_days SMALLINT -- claim lag days,
days_ar SMALLINT -- days in AR,
load_dt TIMESTAMP_NTZ NOT NULL -- load timestamp
);
Standard Snowflake DDL for the canonical finance table. Convert to BigQuery or Databricks →
Why This Term Matters
Healthcare data terminology is foundational for any data engineer working in this industry. Precise understanding of standard terms enables accurate schema design, reduces downstream data quality issues, and ensures pipelines meet the regulatory and interoperability requirements imposed by HIPAA, HL7 FHIR, and CMS reporting frameworks. Without this foundation, even technically well-built pipelines produce data that fails validation when it reaches payers or regulators.
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