Definition
Institutional billing covers facility charges for rooms, nursing, equipment, supplies, and other resources. Claims go on the UB-04 paper form, also called the CMS-1450, or the 837I electronic transaction. They use revenue codes and type of bill codes, and inpatient stays group into diagnosis-related groups (DRGs).
Why it matters
Facility claims carry more data than professional claims, including occurrence, condition, and value codes. A wrong type of bill or revenue code can deny the claim or price it under the wrong payment method. Chargemaster errors repeat on every facility claim.
Example
A hospital outpatient surgery generates a UB-04 with revenue codes for operating room time, recovery, and drugs. The surgeon’s fee goes separately on a CMS-1500.