Which statement correctly identifies the TOB codes for outpatient claims?

• A. TOB 11x or 12x
• B. TOB 13x, 22x
• C. TOB 21x
• D. TOB 31x

Answer: (B)

Type of Bill (TOB) is the four-digit code on the UB-04 that tells the payer the setting and status of the claim. The first digit indicates the broad category, and the remaining digits refine the exact situation. For outpatient claims, the codes that are used are 13x and 22x. The 13x group covers standard hospital outpatient services—things like clinic visits, outpatient departments, ED visits, and observation that do not involve formal inpatient admission. The 22x group covers other outpatient facility-based services where the claim is still processed as outpatient, not as an inpatient admission. Codes in the 11x, 12x, 21x, or 31x ranges indicate inpatient or other non-outpatient statuses, so they do not apply to outpatient claims. Thus, 13x and 22x correctly identify the outpatient TOB codes.