Skip to Main Content
 
 
 
Web Content Viewer

Manuals

Web Content Viewer

FISS/DDE Provider Online Guide: Resources


FISS UB-04 Data Entry Payer Codes

The following payer codes may be reported in the CD field on CLAIM PAGE 03 of the online UB-04 claim entry record.

Payer Code Description
1 Medicaid
2 Blue Cross
3 Other
A Working Aged
B ESRD beneficiary in coordination with an EGHP
D Automobile, no-fault or any liability insurance
E Workers’ Compensation (WC)
F Public Health Service (PHS) or other federal agency
G Disabled
H Federal Black Lung program
I Veterans Administration
L Liability
W WC set aside
Z Medicare Part A (and Part B of A)

 

FISS/DDE Provider Online Guide: Resources - FISS UB-04 Data Entry Payer Codes
Web Content Viewer
Web Content Viewer
Complementary Content