MedicaidBilling CodesHigh impact
Type of Bill and Patient Status Codes
Blue Cross Blue Shield of North Dakota·ND·Provider News
Effective date
Jul 24, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of North Dakota has identified frequent billing errors with Medicaid Expansion claims where providers are using incorrect Type of Bill (TOB) and patient status code combinations. Providers are incorrectly using inpatient status codes (like 30, 09) with outpatient TOB codes (131, 851, 891), when outpatient services should use discharge status 01.
Action Required
Immediately: Billing team must review all Medicaid Expansion claims to ensure correct TOB and patient status code combinations. For outpatient services using TOB 131, 851, or 891, use discharge status code 01 (patient went home) instead of inpatient status codes 30 or 09. Void incorrectly submitted claims and resubmit with proper status codes. Update billing system edits to prevent future incorrect combinations.