Medical Data Call—Place of Service Crosswalk

The Medical Data Call includes the Place of Service code, which identifies where the medical service was performed. The Place of Service code is reported in field 27, positions 282–289 on the Medical Data Call record layout. Refer to the Medical Data Call Reporting Guidebook, Part 5, Data Dictionary, for additional information on this data element.

For physician-related services, the appropriate form is the Centers for Medicare & Medicaid Services (CMS) Health Insurance Claim Form, known as Form CMS-1500. The Place of Service code is reported in field 24B on CMS-1500.

For facility and hospital services, the appropriate form is the National Uniform Billing Committee (NUBC)-approved UB-04 Claim Form, also known as CMS-1450. While the Place of Service is not reported on this form, the Type of Bill is reported in field 4 on CMS-1450. Also, while the Type of Bill is a three-digit code, some providers report it as a four-digit code, with the first digit being a leading zero. 

Because the Medical Data Call requires the Place of Service code, a solution was needed for facility and hospital services using Form CMS-1450. This solution was the development of the Place of Service Crosswalk—as described in the next section of this article.

NCCI Place of Service Crosswalk

In order to report the Place of Service code for facility and hospital services on the Medical Data Call, we have developed a Place of Service Crosswalk, which derives the Place of Service code from the Type of Bill code. We are offering the Crosswalk as a downloadable PDF:

View the complete PDF: Place of Service Crosswalk 

Following is an example of the Place of Service Crosswalk, showing how a specific Type of Bill code maps to the appropriate Place of Service code for Medical Data Call reporting.