U.S. Department of Health and Human Services

Part 5, Chapter 5: Manual Exhibit 5-5-13A

Sub Object Class Codes
Processed and Paid by the IHS FI

Sub Object Class Code	Description
21.85	Patient and Escort Travel: Includes travel and related costs, e.g., lodging, meals, etc.
25.2A	Medical Lab Services-Outpatient Non-IHS: Includes laboratory costs for outpatients at contract facilities. If pathologists and lab fees are invoiced together use 25.2A. Excludes pathologist professional fee invoiced separately (use 25.4D).
25.2B	Medical Lab Services-Inpatient & Outpatient IHS facility: Includes all laboratory costs for inpatients and outpatients at IHS facilities who are referred to contract facilities. Excludes pathologist professional fee invoiced separately (use 25.4C).
25.2D	Dental Lab Services: Includes dental prosthetic fabrication services provided by dental laboratories. Excludes any dentist professional fee (use 25.4E).
25.2G	Non-Federal Hospitalization: Includes inpatient services in non-Federal hospitals.
25.2H	X-Ray Services-Outpatient Non-IHS: Includes X-ray services for outpatients at contract facilities. If radiologist and facility fees are invoiced together, use 25.2H. Excludes radiologist professional fee invoiced separately (use 25.4D).
25.2J	X-Ray Services-Inpatient & Outpatient IHS: Includes all radiology costs for inpatients and outpatients at IHS facilities who are referred to contract facilities. Excludes radiologist professional fee invoiced separately (use 25.4C).
25.2L	Hospital Outpatient: Includes ambulatory care services at contract hospitals other than emergency room services. Excludes any physician professional fee billed separately (see 25.4D).
25.2M	Extended Care Facilities: Includes rehabilitation, skilled nursing facilities, psychiatric inpatient facilities, and psychiatric inpatient care in an acute facility exceeding 30 days. Excludes any physician fee (use 25.4B).
25.2Q	Emergency Room Services: Includes non-IHS hospital emergency room services. Includes any ER physician fees, whether combined or billed separately.
25.2S	Physical Therapy Services: Includes all contract physical therapy services invoiced separately. Excludes all physician professional fees (use 25.4D).
25.4A	Physician Inpatient-IHS Facility: Includes contract physician services for patient hospitalized in IHS facilities. Includes radiologist and pathologist professional fees invoiced separately.
25.4B	Physician Inpatient Non-IHS-Facility: Includes all physician services for patients hospitalized in non-IHS facilities. Includes radiologist and pathologist professional fees invoiced separately. Distinguish physician visits to extended care facilities by using cost center 575.
25.4C	Physician Outpatient-IHS Facility: Includes all contract physician services for outpatients in IHS facilities. Includes radiologist and pathologist professional fees invoiced separately.
25.4D	Physician Outpatient-Non-IHS Facility: Includes all contract physician services of outpatients in non-IHS facilities/physician offices. Includes radiologists and pathologists professional fees invoiced separately. Includes combined hospital outpatient visit and physician services. Excludes emergency room visits billed separately (use 25.2Q). Excludes physician visits to SNFs (use 25.4B).
25.4E	Dentists: Includes all services provided by dentists to inpatients and outpatients. Includes combined dental laboratory costs and dental services. Use 25.2D for laboratory services billed separately.
25.4G	Fee Basis Specialist-IHS Facility: Includes all consultant services other than physicians. Examples are nurse anesthetists, audiologists, speech therapists, podiatrists, and dental hygienists (cost centers 268 & 368).
25.4J	Fee Basis Specialist-Non-IHS Facility: Includes all consultant services in non-IHS facilities by other physicians. Examples are--nurse anesthetists, audiologists, dental hygienists, and podiatrists.
25.4L	Refractions-IHS/Non-IHS Facilities: Eye and vision exams only, not for injuries or other medical reasons, by ophthalmologists and optometrists.
26.3A	Consumable Medical and Surgical Supplies: Includes medical, dental, and surgical supplies. Examples are dressings, bandages, catheters.
26.3G	Nonconsumable Medical and Surgical Supplies: Includes rental and purchase of wheelchairs, apnea monitors, oxygen tanks, beds, etc.
26.3K	Eyeglasses: Includes eyeglasses and repair to eyeglasses. If eyeglasses are billed with the professional fee use 26.3K.
26.3L	Hearing Aids: Includes costs of hearing aid devices and repairs to hearing aids.
43.19	Interest.