Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 18, 2014

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: In the EDGE Server Business Rules (ESBR) there is a rule on inpatient overlapping stay logic. What determines an inpatient claim - is Bill Type code used to segregate inpatient and outpatient claims?

Answer: The Bill Type is used to distinguish inpatient from outpatient claims. The list of Bill Types and how they are classified (inpatient or outpatient) may be found on REGTAP.

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