Help Desks / Support Centers

(800) 457-4454
in-state toll-free or
(501) 376-2211
local and out-of-state

Arkansas Payment Improvement Initiative
(866) 322-4696 in-state toll-free or
(501) 301-8311 local and out-of-state

Magellan Medicaid Administration Pharmacy Help Desk
(800) 424-7895, Option 2 for Prescribers

Long Term Care Codes

Updated 12/22/11
If you are billing for Long Term Care services, you need the following codes, which are used only for Long Term Care.

Type of Bill
(First and Second Digits)
Description
21 Skilled Nursing Facility (SNF) Inpatient
22 Skilled Nursing Facility (SNF) Inpatient, Part B
23 Skilled Nursing Facility (SNF) Outpatient
24 Skilled Nursing Facility (SNF) Outpatient, Other
25 Skilled Nursing Facility (SNF) Intermediate Care-I
26 Skilled Nursing Facility (SNF) Intermediate Care-II
27 Skilled Nursing Facility (SNF) Intermediate Care-III
28 Skilled Nursing Facility (SNF) Swing Beds
51 Skilled Nursing Facility – Extended Care Inpatient
52 Christian Science Hospital – Extended Care Inpatient, Part B
53 Christian Science Hospital – Extended Care Outpatient
54 Christian Science Hospital – Extended Care Outpatient, Other
55 Christian Science Hospital – Extended Care Intermediate Care-I
56 Christian Science Hospital – Extended Care Intermediate Care-II
57 Christian Science Hospital – Extended Care Intermediate Care-III
58 Christian Science Hospital – Extended Care Swing Beds
61 Intermediate Care Facility (ICF) Inpatient
62 Intermediate Care Facility (ICF) Inpatient, Part B
63 Intermediate Care Facility (ICF) Outpatient
64 Intermediate Care Facility (ICF) Outpatient, Other
65 Intermediate Care Facility (ICF) Intermediate Care-I
66 Intermediate Care Facility (ICF) Intermediate Care-II
67 Intermediate Care Facility (ICF) Intermediate Care-III
68 Intermediate Care Facility (ICF) Swing Beds
81 Special Facility Non-Hospital / Hospice
82 Special Facility Hospital / Hospice

Type of Bill
(3rd Digit)
Description
1 Admit Through Discharge Claim
2 Interim – First Claim
3 Interim – Continuing Claims
4 Interim – Last Claim
8 Void/Cancel of a Prior Claim

Patient Status Description
01 Discharged to Home or Self Care
02 Discharged/Transferred to Another Short-Term General Hospital
03 Discharged/Transferred to SNF
04< Discharged/Transferred to an Intermediate Care Facility (ICF)
05 Discharged/Transferred to Another Type of Institution
06 Discharged/Transferred to Home Under Care of Organized
Home Health Service Organization
07 Left Against Medical Advice
20 Expired
30 Still Patient

Home Style Revenue Codes Description
0184 LOA Home - Home Style Facility
0186 LOA Hospital 85% or Greater Occupancy - Home Style Facility
0187 LOA Hospital Less Than 85% Occupancy - Home Style Facility
0188 LOA No Pay – Home Style Facility
0199 Home Style Facility
659 Hospice – Home Style Facility

Traditional Style Revenue Codes Description
0180 LOA Hospital Less Than 85% Occupancy No Pay
0183 LOA Home
0185 LOA Hospital 85% or Greater Occupancy
0189 LOA No Pay
0190 Skilled Nursing
0191 Intermediate I
0192 Intermediate II
0193 Intermediate III
0194 ICF/IID (LOC 28)
658 Hospice