Instead, you must click below on the button labeled "I DO NOT ACCEPT" and exit from this computer screen. An official website of the United States government. 222 0 obj
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21-29 Reserved for National Assignment These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright 2002, 2004 American Dental Association (ADA). Whether the bed is Medicare certified or not. 05 Discharged/Transferred to Another Type of Health Care Institution Not Defined Elsewhere in This Code List incorporated into a contract. The ADA does not directly or indirectly practice medicine or dispense dental services. If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems. All Hospice and Home Health Claims (TOBs 32X, 33X, 34X, 81X and 82X). In cases in which two or more patient discharge status codes apply, providers should code the highest level of care known. 31-39 Reserved for National Assignment This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes all devices/storage media attached to this system. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. This sdtc:dischargeDispositionCode SHOULD contain exactly [0..1] code, which SHOULD be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status WebThey are generally infections that occur more than 48 to 72 hours after _____ and within 10 days after hospital discharge. Secure .gov websites use HTTPSA Patient discharge status Code 66 is used to identify a transfer to a critical access hospital (CAH) for inpatient care. For hospitals with an approved swing bed arrangement, providers should use Code 61- Swing Bed. DISCLAIMER: The contents of this database lack the force and effect of law, except as 0000001199 00000 n
THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. 40 Expired at Home This code is for use only on Medicare and TRICARE claims for hospice care; The patient does not qualify for skilled level of care outside the hospice benefit for conditions unrelated to the terminal illness; and 0000109611 00000 n
By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. WebConstrained to codes in the Discharge Disposition: Discharge To Acute Care Facility value set (2.16.840.1.113883.3.117.1.7.1.87) QDM Attribute and Definition (QDM Version 0000004341 00000 n
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Answer: Episodes for patients discharged to a non-institutional (home) hospice (M0100 Reason for assessment RFA 9 Discharge from Agency) where M2420 Discharge Disposition is coded with Response 3 Patient transferred to a non-institutional hospice, and with a M0906 Discharge/Transfer/Death Date of 1/1/2023 or The definitions of discharges and transfers under the inpatient prospective payment system (IPPS) are in 42 CFR 412.4(a) and (b). 01 Discharged to home or self care (routine discharge) 02 Discharged/transferred to a short-term general hospital for inpatient care. You may also contact AHA at ub04@healthforum.com. End users do not act for or on behalf of the CMS. %PDF-1.4
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10-19 Reserved for National Assignment trailer
Please. United HealthCare Community Plan requires Patient Discharge Status codes for: ** Hospital Inpatient Claims (TOBs 11X and 12X); You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. UnitedHealthCare Community Plan will deny claims when the Patient Discharge Status is inconsistent with the type of bill reported. Choosing the patient discharge status code correctly avoids claim errors and helps you receive payment for your claim sooner. 04 Discharged/Transferred to an Intermediate Care Facility (ICF) License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. 0000000813 00000 n
CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Note: This code should not be used when a patient is transferred to an inpatient psychiatric unit of a federal hospital (e.g., Veterans Administration Hospitals). Some of the descriptions of the discharged status codes were changed prematurely. %%EOF
4. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, Medicare revalidation process how often provide need to do FAQ, Step by step Guide Medicare participation program. IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK ABOVE ON THE LINK LABELED "I Do Not Accept" AND EXIT FROM THIS COMPUTER SCREEN. If you do not agree to the terms and conditions, you may not access or use the software. When a patient is discharged from an acute hospital to a Critical Access Hospital (CAH) swing bed, use patient discharge status code 61. ( 0000006885 00000 n
It is used for inpatient claims when billing for leave of absence days or interim billing (i.e., the length of stay is longer than 60 days). ; 1. 0000014725 00000 n
20 Expired All Rights Reserved (or such other date of publication of CPT). The appropriate type of bill is determined based on the following guidance from the NUBC: Therefore, you have no reasonable expectation of privacy. 0000002464 00000 n
On September 26, 2019, the Centers for Medicare and Medicare Services (CMS) released the final rule on discharge planning requirements (the Final Rule) in an effort to empower patients to be active participants in the discharge planning process. The site is secure. U.S. Department of Health & Human Services The Department may not cite, use, or rely on any guidance that is not posted The scope of this license is determined by the AMA, the copyright holder. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. Clinical Focus: This value set contains concepts that represent a patient leaving against medical advice. A federal government website managed by the 0000010530 00000 n
A list of (National Cancer Institute) Designated Cancer Centers can be found at http://cancercenters.cancer.gov/cancer_centers/cancer-centers-names.html on the Internet. Any communication or data transiting or stored on this system may be disclosed or used for any lawful Government purpose. CDT is a trademark of the ADA. 08. According to the NUBC, discontinued services may include: The CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. 0000003963 00000 n
07. At any time, and for any lawful Government purpose, the government may monitor, record, and audit your system usage and/or intercept, search and seize any communication or data transiting or stored on this system. authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically In addition, CMS has added a specific code for discharges related to disaster situations. 0000005441 00000 n
These patient discharge status codes are reserved for national assignment. All Hospice and Home Health Claims (TOBs 32X, 33X, 34X, 81X and 82X). Patients who leave before triage, or are triaged and leave without being seen by a physician; or IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THESE AGREEMENTS CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. 52-60 Reserved for National Assignment 222 42
This code should be reported when a patient is: 0000014662 00000 n
61 Discharged/Transferred to a Hospital-based Medicare Approved Swing Bed A patient discharge status code is a two-digit code that identifies where the patient is at the conclusion of a health care facility encounter (this could be a visit or an actual inpatient stay) or at the time end of a billing cycle (the through' date of a claim). + |
The ADA is a third-party beneficiary to this Agreement. %PDF-1.6
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This license will terminate upon notice to you if you violate the terms of this license. Heres how you know. Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. 3. No fee schedules, basic unit, relative values or related listings are included in CPT. hb```b``fa`2lx$e6~-Ud_I*ee^#}R hVc`@Yf,|@A4rDuD8*6cuPC>C[30 i) w=X`` 0000003710 00000 n
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<. 50 and 51 Discharged/Transferred to a Hospice You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. 0000048901 00000 n
Patient discharge status Code 50 should be used if the patient went to his/her own home or an alternative setting that is the patients home, such as a nursing facility, and will receive in-home hospice services. Making copies or utilizing the content of the UB-04 Manual or UB-04 Data File, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual / Data File or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. These codes are important in understanding the discharge status as reported to CMS by the hospital and may impact post-acute Medicare Part A coverage in the skilled nursing facility and home care. 836 0 obj
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Overall: 78 percent of patients discharged to hospice care in 2021 were placed in home hospice compared to facility hospice. Providers will need to establish a process for identifying whether a hospital is paid under the PPS or whether the facility is designated as a CAH. ** The first digit is a leading zero. Based on national guidelines for completing and submitting a UB-04 (or the electronic comparative) a provider must assign a Patient Discharge Status code which aligns with the type of bill (TOB) submitted. These 2023 ICD-10-CM codes are to be used for discharges occurring from October 1, 2022 through September 30, 2023 and for patient encounters occurring from October 1, 2022 through September 30, 2023. Note: The information obtained from this Noridian website application is as current as possible. endstream
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To sign up for updates or to access your subscriber preferences, please enter your contact information below. Correction to Patient Discharge Status Codes in Medicaid Providers Manual Information posted February 1, 2013. 0000006792 00000 n
The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. Official websites use .govA Code 03 should not be used if the patient is admitted to a non-Medicare certified area. 09. This includes but is not. Webwhich tools would you use to make header 1 look like header 2 The .gov means its official. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. Discharged/transferred to a designated cancer center or children's hospital. 0000007191 00000 n
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2. You acknowledge that the AMA holds all copyright, trademark, and other rights in CPT. This code is used when the patient is still within the same facility and is typically used when billing for leave of absence days or interim bills. AMA Disclaimer of Warranties and Liabilities The files in the Downloads section below contain information on the ICD-10-CM updates effective with discharges on and after April 1, 2023. All rights reserved. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. H|TM0WJ*a8viUi%]n)X*VLb;273~y[Lu. CMS Change Request, CR10602 - Update to the Hospital Transfer 0
The Centers for Medicare and Medicaid Services (CMS) issued two Medlearn Matters articles under the heading of Clarification of Patient Discharge Status Codes and Hospital Transfer Policies and numbered SE0801 and SE1411. 0000007325 00000 n
Transferred to a hospital or hospital unit that hasnt been officially determined as being excluded from IPPS such as: An acute care hospital that would otherwise be eligible to be paid under the IPPS, but doesnt have an agreement to participate in the Medicare Program (Patient Discharge Status Code 02 or Planned Acute Care Hospital Inpatient Readmission Patient Status Code 82), A Critical Access Hospital (Patient Discharge Status Code 66 or Planned Acute Care Hospital Inpatient Readmission Patient Status Code 94). Department of Defense hospitals; NUBC clarified the following Hospice Levels of Care: Still others elect not to certify any of their beds under Medicare. [ Modified: 8.5.108.11, 8.5.146.06] The Workspace Disposition Code view X XMCE 5764.2 FISS shall map patient discharge status code 70 to IPPS Pricer review code 00 (as is Q: Can Patient Discharge Status Code 30, Still a Patient, be used on both inpatient and outpatient claims? `U~F+$4h CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT-4. ** Skilled Nursing Claims (TOBs 18X, 21X, 22X and 23X); The table included patient discharge status codes that are not available in the TMHP claims processing system: Users must adhere to CMS Information Security Policies, Standards, and Procedures. Discharged from acute hospital care but remains at the same hospital under hospice care, Any questions pertaining to the license or use of the CDT should be addressed to the ADA. 0000004018 00000 n
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on the guidance repository, except to establish historical facts. Reimbursement Guidelines from UHC insurance. 06. The intent of this data element is to identify the final place or setting to which the patient was discharged on the day of 0000003940 00000 n
0000001920 00000 n
0000002063 00000 n
WebThis is the current published version in it's permanent home (it will always be available at this URL). o 70 Discharged/transferred to another type of health-care institution not defined elsewhere in the patient discharge status code table License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. 0000109340 00000 n
Service Desk. ["Discharge Disposition": "Discharge To Acute Care Facility"], Eligible Hospital / Critical Access Hospital eCQMs, FHIR - Fast Healthcare Interoperability Resources, QRDA - Quality Reporting Document Architecture, CMS105v9 - Discharged on Statin Medication, CMS71v10 - Anticoagulation Therapy for Atrial Fibrillation/Flutter, CMS104v9 - Discharged on Antithrombotic Therapy. Bookmark |
No fee schedules, basic unit, relative values or related listings are included in CDT-4. Issued by: Centers for Medicare & Medicaid Services (CMS). The disposition, or location to which the patient is transferred at the time of hospital discharge. All the articles are getting from various resources. This code should be used when transferring a patient to a LTCH. Inpatient rehabilitation facilities (or designated units) are those facilities that meet a specific requirement that 75% of their patients require intensive rehabilitative services for the treatment of certain medical conditions. The hospital must have an effective discharge planning process that focuses on the patient's goals and treatment preferences and includes the patient and his or her caregivers/support person(s) as active partners in the discharge planning for post-discharge care. CPT is a trademark of the AMA. 41 Expired in a Medical Facility, such as a hospital, SNF, ICF, or free-standing hospice; and wKb${aY]YlYwKr{l."T-g3q,$I=hS!b
;fj5Ku{:m3>g'9?0"y*Ieo&5qMHtZT`;QA]Uv|:Z{9,VGk,}D=aS&=JE(e;J)yXHUB3'SqM`}tu;nvkuO?O%Fi X.
In an effort to better enable the collection of health-related social needs (HRSNs), defined as individual-level, adverse social conditions that negatively impact a persons health or healthcare, are significant risk factors associated with worse health outcomes as well as increased healthcare utilization, the Centers for Disease Control and Preventions (CDC) National Center for Health Statistics (NCHS) is implementing 42 new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting effective April 1, 2023. 0000014517 00000 n
Upon discharge, the patient is transferred as a new nursing home placement to a designated hospice unit/bed. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. This includes items such as CPT codes, CDT codes, ICD-10 and other UB-04 codes. Last Updated: Jul 08, 2021 A: Yes, it can be used on both types of claims. 0000003110 00000 n
The NUBC has also clarified that this code should also be used when a patient is transferred to an inpatient psychiatric unit of a Veterans Administration hospital. Web The Centers for Medicare & Medicaid Services (CMS) requires patient discharge status codes for: Hospital Inpatient Claims (type of bills (TOBs) 11X and 12X); Skilled This code should not be used for home health services provided by a: Any questions pertaining to the license or use of the CPT must be addressed to the AMA. There are times in which the various content contributor primary resources are not synchronized or updated on the same time interval. Discharge status code list. WebThe disposition, or location to which the patient is transferred at the time of hospital discharge. hbbd``b`f " BD
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Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. 2750 0 obj
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MLN Matters article SE0801 is provided to assist providers in determining the right discharge status code to use with their claims. The fourth digit is commonly referred to as the frequency code. IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "I DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN. Return to the Patient List view and click the minutes ago button to refresh your patient list 3. Transferred from an inpatient acute care hospital to a Medicare-certified SNF under the following conditions: DISCLAIMER: The contents of this database lack the force and effect of law, except as Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. Home IV provider for home IV services. 0000002026 00000 n
CPT 91311, 0111A, 0112A Covid Vaccine for children, 5 Important points to improve claim submission success rate. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically Webmedical record. CMS Disclaimer Email |
For U.S. Government and other information systems, information accessed through the computer system is confidential and for authorized users only. For non-emergency services & during normal business hours, please submit a ticket online by clicking here: A patient discharge status code is a two-digit code that identifies where the patient is at the conclusion of a health care facility encounter (this could be a visit or an actual inpatient stay) or at the time end of a billing cycle (the through date of a claim). 02 Discharged/Transferred to a Short Term General Hospital for Inpatient Care CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. 0000001396 00000 n
). The 2023 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2023. To assist in the proper coding of a patient discharge status code, you may access data elements, codes, and FAQs by referring to the UB-04 Data Specifications Manual on the National Uniform Billing Committee website. Patient Discharge Status Code Definition. Overall: 78 percent of patients discharged to hospice care in 2021 were placed in home hospice compared to facility hospice. ~``P(p#mC??``dR/6d`` = _=
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** Outpatient Hospital Claims (TOBs 13X, 14X, 71X, 73X, 74X, 75X, 76X and 85X); and Discharges or transfers to long-term care hospitals (LTCHs) should be coded with Patient discharge status Code 63. Assigning the correct patient discharge The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. Cancer hospitals excluded from Medicare Prospective Payment System (PPS) and childrens hospitals are examples of such other types of health care institutions. or No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. Patient discharge status code 04 is typically defined at the state level for specifically designated A federal government website managed by the Therefore, it is recommended that if a patient is going home or to an institutional setting with a hospice referral only (without having already been accepted for hospice care by a hospice organization), the patient discharge status code should simply reflect the site to which the patient was discharged; not hospice (i.e., 01: home or self care, or 04: an intermediate care nursing facility, assuming it is not a Medicare SNF admission). 0000007895 00000 n
CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. 0000002967 00000 n
This code should be used when a patient is transferred to a facility or designated unit that meets this qualification. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. The AMA is a third-party beneficiary to this license. 0000109996 00000 n
on the guidance repository, except to establish historical facts. , November 23, 2016 - Revised March 18, 2021, Patient discharge status codes identify where a patient is at the conclusion of a health care facility encounter or at the end of a billing cycle. Washington, D.C. 20201 0000003474 00000 n
CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. This code applies to discharges and transfers to a government operated health care facility including: To designate patients that are discharged/transferred to a nursing facility with neither Medicare nor Medicaid certification, or 2023 Alora Healthcare Systems, LLC. 63 Discharged/Transferred to Long Term Care Hospitals (LTCHs) A type of bill with a frequency reflective of an ongoing stay should align with a discharge status indicating that the patient is still receiving care. New Patient Discharge Status Code 21 to Define Discharges or Transfers to Court/Law Enforcement This article is based on Change Request (CR) 6385 which These materials contain Current Dental Terminology, (CDT), copyright 2020 American Dental Association (ADA). .gov 42 Expired Place Unknown; This code is for use only on Medicare and TRICARE claims for hospice care. Inpatient Respite Patient discharge status code 51: Hospice medical facility should be used if the patient went to a facility that is qualified and the patient is receiving hospice inpatient respite level of care. 03 Discharged/Transferred to a Skilled Nursing Facility (SNF) with Medicare Certification in Anticipation of Skilled Care hmo0^P?]&
V5hTED 44-49 Reserved for National Assignment xb```b``ud`e`` @1V@ olvqZ304/aPhxDdA b~hQ[{6~()`vA'O%j_ "hl6J *A
Bs@(P4G@{ - It is important to select the correct patient discharge status code. The ADA is a third-party beneficiary to this Agreement. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. ( Click here to review the rule in the Federal Register.) 0000006647 00000 n
CMS requires patient discharge status codes for: In addition, CMS emphasizes that proper discharge coding is just as critical a factor in ensuring proper claims filing and processing as any other coding and providers are responsible for ensuring accurate discharge designations. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. For reporting other discharges/transfers to nursing facilities, providers should see codes 04 and 64. 01- Discharge to Home or Self Care (Routine Discharge) 200 Independence Avenue, S.W. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Answer: Episodes for patients discharged to a non-institutional (home) hospice (M0100 Reason for assessment RFA 9 Discharge from Agency) where M2420 Discharge Disposition is coded with Response 3 Patient transferred to a non-institutional hospice, and with a M0906 Discharge/Transfer/Death Date of 1/1/2023 or If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "I ACCEPT".
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