CL1

Institutional Claim Code

Pos: 110

Max: 1

Detail - Optional

Loop: 2000F

Elements: 4

User Option (Usage): Situational

To supply information specific to hospital claims

Element Summary:

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	CL101	1315	Admission Type Code Description: Code indicating the priority of this admission CODE SOURCE: 231: Admission Type Code Required if requesting admission to a hospital for inpatient services.	O	ID	1/1	Situational

	ExternalCodeList
	Name: 231
	Description: Admission Type Code

CL102

1314

Admission Source Code
Description: Code indicating the source of this admission
CODE SOURCE: 230: Admission Source Code
Used only when certification requires information on the admission source that is not provided in the Requester Loop 2000B.

1/1

Situational

	ExternalCodeList
	Name: 230
	Description: Admission Source Code

CL103

1352

Patient Status Code
Description: Code indicating patient status as of the "statement covers through date"
CODE SOURCE: 239: Patient Status Code
Use only for inpatient services. Under most circumstances, this data element is not used.

1/2

Situational

	ExternalCodeList
	Name: 239
	Description: Patient Status Code

CL104

1345

Nursing Home Residential Status Code
Description: Code specifying the status of a nursing home resident at the time of service
Use only when certification involves a nursing home resident.
All valid standard codes are used.

1/1

Situational

Notes:

1. Use only when requesting certification for admission (UM01 = AR) to a facility.

Example:

CL1*3**01~

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