Claim edit: Invalid admission type code

Stedi now rejects 837I institutional claims with an invalid admission type code.

How the edit works

In institutional inpatient claims, an admission type code indicates the general nature of a patient’s admission. It provides context about the urgency or purpose of the hospital admission.

Admission type code

Admission type codes are defined by the National Uniform Billing Committee (NUBC). Valid admission type codes are:

• 1 – Emergency

• 2 – Urgent

• 3 – Elective

• 4 – Newborn

• 5 – Trauma Center

• 9 – Information Not Available

If an institutional claim includes an invalid admission type code, such as 6 or 0, the payer may reject the claim.

This edit catches the issue before the claim reaches the payer. It prevents payer rejections, which take longer to resolve and delay payment for the provider.

Rejection errors

If you submit a claim using Stedi's Claim Submission API endpoints and the claim fails the edit, you'll get back an error response in real time. The response includes details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid Admission Type Code. The submitted admission type code, 0 is not a recognized value. The value must be valid per NUBC Priority (Type) of Admission or Visit Codes. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim using SFTP and the claim fails the edit, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, and error message:

STC*A7>231*[DATE]*U*[AMOUNT]********Invalid Admission Type Code. The submitted admission type code, 0 is not a recognized value. The value must be valid per NUBC Priority (Type) of Admission or Visit Codes. Correct and resubmit.~