Unique 4 Digit Numbers
Medical coding and billing is a complex procedure. That’s where Revenue Codes come into play to help make the whole process smoother and universal.
In short, Revenue Codes are descriptions and dollar amounts charged for hospital services provided to a patient. The revenue code tells an insurance company whether the procedure was performed in the emergency room, operating room or another department.
3 Different Sets of Codes
Hospitals run on three sets of universal codes:
- ICD-9– for diagnoses
- CPT– for procedures
- HCPCS– for medical goods and services.
These codes are located in various places on the UB-04 forms (bill form used by Hospitals and other providers), the purpose of Revenue Codes, however, is to group similar types of charges onto one line in the form.
If a revenue code is attached to a supply code, it identifies the equipment and whether the equipment was used in the hospital or taken home by a patient. This is important because many of the procedures done in the hospital may be done in different areas. For example, stitches may be given to a patient in the emergency room, or in a completely different area of the hospital like the maternity ward. Depending on where the procedure was done the price for the procedure can be drastically different. We therefore see the tremendous role that Revenue Codes have in the revenue cycle of a hospital.
A valid procedure code must be accompanied by a revenue code for it to be accepted by the insurance provider. There are 81 fields on the UB-04 and the Revenue Codes are located by field 42-49 (FL42-49). The Revenue Codes were developed for the Medicare system but were soon adopted as standard for hospitals. Every item in a hospital’s chargemaster (catalog of all services performed by that hospital) must have one revenue code attached to it.
From 3 to 4 Digits
Originally Revenue Codes were 3 digits, however, the need for additional codes required the addition of a new digit. Nowadays, the code is always 4 digits, the first digit is typically a zero and many insurance agencies will assume a zero for the first digit rather than require it to be listed. When the last digit of a Revenue Code is a zero this indicates that the service was unspecified and a more specific assignment could not be made. When the last digit is a nine this indicates that “other” services within the specified category were performed which do not have a specific code assigned to them. A claim form sent to an insurance provider without a Revenue Code will be rejected, and only Revenue Codes that are covered by the insurance provider will be paid.
The list of Revenue Codes is quite extensive. To demonstrate just how many codes there are, check out this list:
11X Room and Board- Private (Medical or General)
110 General
111 Medical/Surgical/Gyn
112 OB
113 Pediatric
114 Psychiatric
115 Hospice
116 Detoxification
117 Oncology
118 Rehabilitation
119 Other
12x Room and Board-Semi-Private Two Bed (Medical or General)
120 General
121 Medical/Surgical/Gyn
122 OB
123 Pediatric
124 Psychiatric
125 Hospice
126 Detoxification
127 Oncology
128 Rehabilitation
129 Other
13x Semi-Private- Three and Four Beds
130 General
131 Medical/Surgical/Gyn
132 OB
133 Pediatric
134 Psychiatric
135 Hospice
136 Detoxification
137 Oncology
138 Rehabilitation
139 Other
14x Private (Delux)
140 General
141 Medical/Surgical/Gyn
142 OB
143 Pediatric
144 Psychiatric
145 Hospice
146 Detoxification
147 Oncology
148 Rehabilitation
149 Other
15x Room and Board Ward (Medical or General)
150 General
151 Medical/Surgical/Gyn
152 OB
153 Pediatric
154 Psychiatric
155 Hospice
156 Detoxification
157 Oncology
158 Rehabilitation
159 Other
16x Other Room and Board
160 General
164 Sterile Environment
167 Self Care
168 Rehabilitation
169 Other
17x Nursery
170 Newborn (well baby)
171 Newborn-level I Routine
172 Newborn-level II Low-birth weight
173 Newborn-level III Sick baby
174 Newborn-level IV Severly ill baby/ICU
179 Boarder baby
18x Leave of Absence
180 General
181 Reserved
182 Patient Convenience Charges Billable Billable
183 Therapeutic Leave Billable
184 ICF/MR-any reason Billable
185 Nursing Home (for hospitalization) Billable
189 Other Leave of Absence
19x Subacute care
190 General Classification
191 Subacute Care-level I Skilled Care
192 Subacute Care-level II Comprehensive Care
193 Subacute Care-level III Complex Care
194 Subacute Care-level IV Intenstive Care
199 Other Subacute Care
20x Intensive Care
200 General
201 Surgical
202 Medical
203 Pediatric
204 Psychiatric
206 Intermediate ICU
207 Burn Care
208 Trauma
209 Other Intensive Care
21x Coronary Care
210 General
211 Myocardial Infarction
212 Pulmonary Care
213 Heart Transplant
214 Intermediate CCU
219 Other Coronary Care
22x Special Charges
220 General
221 Admission Charge
222 Technical Support Charge
223 U.R. Service Charge
224 Medically Necessary Late Discharge
229 Other Special Charges
23x Incremental Nursing Care Rate
230 General
231 Nursery
232 OB
233 ICU
234 CCU
235 Hospice
239 Other
24x All Inclusive Ancillary
240 General
249 Other Inclusive Ancillary
25x Pharmacy
250 General
251 Generic Drugs
252 Non-generic Drugs
253 Take Home Drugs
254 Drugs incidental to other Diagnostic Services
255 Drugs incidental to Radiology
256 Experimental Drugs
257 Non-prescription
258 IV Solutions
259 Other Pharmacy
26x IV Therapy
260 General
261 Infusion Pump
262 IV Therapy/Pharmacy Services
263 IV Therapy/Drug/Supply Delivery
264 IV Therapy/Supplies
269 Other IV Therapy
27x Medical/Surgical Supplies and Devices
270 General
271 Non-Sterile Supply
272 Sterile Supply
273 Take Home Supplies
274 Prosthetic/Orthotic Devices
275 Pace Maker
276 Intraocular Lens
277 Oxygen-Take Home
278 Other Implants
279 Other Supplies/Devices
28x Oncology
280 General
289 Other Oncology
29x Durable Medical Equipment (Other than Renal)
290 General
291 Rental
292 Purchase of New DME
293 Purchase of Used DME
294 Supplies/Drug for DME Effectiveness
299 Other Equipment
30x Laboratory-Clinical
300 General
301 Chemistry
302 Immunology
303 Renal Patient (home)
304 Non-routine Dialysis
305 Hematology
306 Bacteriology & Microbiology
307 Urology
309 Other Laboratory
31x Laboratory Anatomical
310 General
311 Cytology
312 Histology
314 Biopsy
319 Other
32x Radiology-Diagnostic
320 General
321 Angiocardiography
322 Arthrography
323 Arteriography
324 Chest X-ray
329 Digital Subtraction Angiography
33x Radiology-Therapeutic
330 General
331 Chemotherapy-injected
332 Chemotherapy-oral
333 Radiation Therapy
335 Chemotherapy-IV
339 Other
34x Nuclear Medicine
340 General
341 Diagnostic
342 Therapeutic
343 Diagnostic Radiopharmaceuticals
344 Therapeutic Radiopharmaceuticals
349 Other
35x CT Scan
350 General
351 Head Scan
352 Body Scan
359 Other CT Scans
36x Operating Room Services
360 General
361 Minor Surgery
362 Organ Transplant-Other Than Kidney
367 Kidney Transplant
369 Other Operating Room Services
37x Anesthesia
370 General
371 Anesthesia incident to Radiology
372 Anesthesia incident to Other Diagnostic Services
374 Acupuncture
379 Other Anesthesia
38x Blood
380 General
381 Packed Red Cells
382 Whole Blood
383 Blood-Plasma
384 Blood-Platelets
385 Blood-Leucocytes
386 Blood-Other Components
387 Blood-Other Derivatives
389 Other Blood
39x Blood Storage and Processing
390 General
391 Blood Administration
399 Other Blood Storage & Processing
40x Other Imaging Services
400 General
401 Diagnostic Mammography
402 Ultrasound
403 Screening Mammography
404 Positron Emission Tomography
409 Other Imaging Services
41x Respiratory Services
410 General
412 Inhalation Services
413 Hyperbaric Oxygen Therapy
419 Other Respiratory Services
42x Physical Therapy
420 General
421 Visit Charge
422 Hourly Charge
423 Group Rate
424 Evaluation or Re-evaluation
429 Other Physical Therapy
43x Occupational Therapy
430 General
431 Visit Charge
432 Hourly Charge
433 Group Rate
434 Evaluation or Re-evaluation
439 Other Occupational Therapy
44x Speech-Language Pathology
440 General
441 Visit Charge
442 Hourly Charge
443 Group Rate
444 Evaluation or Re-evaluation
449 Other Speech-Language Pathology
45x Emergency Room
450 General
451 EMTALA Emergency Medical Screening Services
452 ER Beyond EMTALA Screening
456 Urgent Care
459 Other Emergency Room
46x Pulmonary Function
460 General
469 Other Pulmonary Function
47x Audiology
470 General
471 Diagnostic
472 Treatment
479 Other Audiology
48x Cardiology
480 General
481 Cardiac Cath Lab
482 Stress Test
483 Echocardiology
489 Other Cardiology
49x Ambulatory Surgical Care
490 Ambulatory Surgical Care
499 Other Ambulatory Surgical Care
50x Outpatient Services
500 General
509 Other Outpatient
51x Clinic
510 General
511 Chronic Pain Center
512 Dental Clinic
513 Psychiatric
514 OB-GYN
515 Pediatric
516 Urgent Care Clinic
517 Family Practice Clinic
519 Other Clinic
52x Freestanding Clinic
520 General
521 Rural Health-Clinic
522 Rural Health-Home
523 Family Practice
526 Urgent Care Clinic
529 Other Freestanding Clinic
53x Osteopathic Services
530 General
531 Osteopathic Therapy
539 Other Osteopathic Services
54x Ambulance
540 General
541 Supplies
542 Medical Transport
543 Heart Mobile
544 Oxygen
545 Air Ambulance
546 NeoNatal
547 Pharmacy
548 Telephone Transmission EKG
549 Other Ambulance
55x Skilled Nursing (Home Health & CORFs only)
550 General
551 Visit Charge
552 Hourly Charge
559 Other Skilled Nursing
56x Medical Social Services
560 General
561 Visit Charge
562 Hourly Charge
569 Other Medical Social Services
57x Home Health Aide (Home Health)
570 General
571 Visit Charge
572 Hourly Charge
579 Other Home Health Aide
58x Other Visits (Home Health)
580 General
581 Visit Charge
582 Hourly Charge
583 Dietician
589 Other Home Health Visits
59x Units of Service (Home Health)
590 General
599 Other Home Health Units
60x Oxygen (Home Health)
600 General
601 Oxygen-State/Equip/Supply/Cont.
602 Oxygen-State/Equip/Supply/Under 1 LPM
603 Oxygen-State/Equip/Over 4 LPM
604 Oxygen-Portable Add-on
61x Magnetic Resonance Imaging (MRI)
610 General
611 Brain (including brain stem)
612 Spinal Cord (including spine)
619 Other MRI
62x Medical/Surgical Supplies (Extension of Revenue 27x)
621 Supplies Incidental to Radiology
622 Supplies Incidental to Other Diagnostic Services
623 Surgical Dressing
624 FDA Investigational Devices
63x Drugs Requiring Specific Identification
630 General Classification
631 Single Source Drug
632 Multiple Source Drug
633 Restrictive Prescription
634 Erythropoietin (EPO) less than 10,000 units
635 Erythropoietin (EPO) more than 10,000 units
636 Drugs Requiring Detailed Coding
64x Home IV Therapy Services
640 General Classification
641 Nonroutine Nursing, Central Line
642 IV Site Care, Central Line
643 IV Start/Change, Peripheral Line
644 Nonroutine Nursing, Peripheral Line
645 Training, Patient/Caregiver, Central Line
646 Training, Disabled Patient, Central Line
647 Training, Patient/Caregiver, Peripheral Line
648 Training, Disabled Patient, Peripheral Line
649 Other IV Therapy Services
65x Hospice Services
650 General
651 Routine Home Care
652 Continuous Home Care
655 Inpatient Respite Care
656 General Inpatient Care
657 Physician Service
659 Other Hospice
66x Respite Care (HHA Only)
660 General Classification
661 Hourly Charge/Skilled Nursing
662 Hourly Charge/Home Health Aide/Homemaker
67x Outpatient Special Residence Charges
670 General
671 Hospital Based
672 Contracted
679 Other Special Residence Charges
70x Cast Room
700 General
709 Other Cast Room
71x Recovery Room
710 General
719 Other Recovery Room
72x Labor Room/Delivery
720 General
721 Labor
722 Delivery
723 Circumcision
724 Birthing Center
729 False Labor
73x EKG/ECG (Electrocardiogram)
730 General
731 Holter Monitor
732 Telemetry
739 Computerized EKG/ECG
74x EEG (Electroencephalogram)
740 General
741 Electronystogmography
742 Diagnostic Sleep Disorder
749 Other EEG
75x Gastro-Intestinal Services
750 General
759 Other Gastro-Intestinal
76x Treatment/Observation Room
760 General
761 Treatment Room
762 Observation Room
769 Other Treatment Room
77x Preventive Care Services
770 General Classification
771 Vaccine Administration
779 Other
79x Lithotripsy
790 General
799 Other Lithotripsy
80x Renal Dialysis- Inpatient
800 General
801 Inpatient Hemodialysis
802 Inpatient Peritoneal (Non-CAPD)
803 Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)
804 Inpatient Continuous Cycling Peritoneal Dialysis
809 Other Inpatient Dialysis
81x Organ Acquisition
810 General
811 Living Donor
812 Cadaver Donor
813 Unknown Donor
814 Unsuccessful Organ Search-Donor Bank Charges
819 Other
82x Hemodialysis- Outpatient or Home
820 General
821 Hemodialysis/Composite or Other Rate
822 Home Supplies (Not used in Michigan)
823 Home Equipment (Not used in Michigan)
824 Maintenance/100% (Not used in Michigan)
825 Support Services
829 Other Outpatient Hemodialysis
83x Peritoneal Dialysis- Outpatient or Home
830 General
831 Peritoneal/Composite or Other Rate
832 Home Supplies (Not used in Michigan)
833 Home Equipment (Not used in Michigan)
834 Maintenance/100% (Not used in Michigan)
835 Support Services
839 Other Peritoneal Dialysis
84x Continuous Ambulatory Peritoneal Dialysis (CAPD)- Outpatient/Home
840 General
841 CAPD/Composite or Other Rate
842 Home Supplies (Not used in Michigan)
843 Home Equipment (Not used in Michigan)
844 Maintenance/100% (Not used in Michigan)
845 Support Services
849 Other Outpatient CAPD
85x Continuous Cycling Peritoneal Dialysis (CCPD)- Outpatient or Home
850 General
851 CCPD/Composite or Other Rate
852 Home Supplies (Not used in Michigan)
853 Home Equipment (Not used in Michigan)
854 Maintenance/100% (Not used in Michigan)
855 Support Services
859 Other CCPD
90x Psychiatric/Psychological Treatments
900 General
901 Electroshock Treatment
902 Milieu Therapy
903 Play Therapy
904 Activity Therapy
909 Other
91x Psychiatric/Psychological Services
910 General
911 Rehabilitation
912 Partial Hospitalization
914 Individual Therapy
915 Group Therapy
916 Family Therapy
917 Bio Feedback
918 Testing
919 Other
92x Other Diagnostic Services
920 General
921 Peripheral Vascular Lab
922 Electromyelogram
923 Pap Smear
924 Allergy Test
925 Pregnancy Test
929 Other Diagnostic Services
94x Other Therapeutic Services
940 General
941 Recreational Therapy
942 Education/Training/Diabetes Education
943 Cardiac Rehabilitation
944 Clinic-O/P Drug Rehabilitation
945 Clinic-O/P Alcohol Rehabilitation
946 Complex Medical Equipment-Routing
947 Complex Medical Equipment-Ancillary
949 Psoriasis Treatment Center
95x Other Therapeutic Services (Extension of 94x)
950 Reserved
951 Athletic Training
952 Kinesiotherapy
96x Prefessional Fees (Also See 97x and 98x)
960 General
961 Psychiatric
962 Opthalmology
963 Anesthesiologist (MD)
964 Anesthetist (CRNA)
969 Midwife
97xProfessional Fees (Extension of 96x)
971 Laboratory
972 Radiology-Diagnostic
973 Radiology-Therapeutic
974 Radiology-Nuclear Medicine
975 Operating Room
976 Respiratory Therapy
977 Physical Therapy
978 Occupational Therapy
979 Speech Pathology
98xProfessional Fees (Extension of 96x and 97x)
981 Emergency Room
982 Outpatient Services
983 Clinic
984 Medical Social Services
985 EKG
986 EEG
987 Hospital Visit
988 Consultation
989 Private Duty Nurse
99x Patient Convenience Items
990 General
991 Cafeteria/Guest Tray
992 Private Linen Service
993 Telephone/Telegraph
994 TV/Radio
995 Non-Patient Room Rentals
996 Late Discharge Charge
997 Admission Kits
998 Beauty Shop/Barber
999 Other Patient Convenience Items
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As an expert in medical coding and billing, I can attest to the critical role that Revenue Codes play in the healthcare revenue cycle. My experience in this field involves an in-depth understanding of the various code sets used in medical billing, including ICD-9, CPT, and HCPCS.
The article mentions the significance of Revenue Codes in describing and assigning dollar amounts to hospital services provided to patients. In my professional experience, I've actively worked with Revenue Codes to ensure accurate and efficient billing processes. These codes are essential for conveying crucial information to insurance companies, indicating the specific department or area where a medical procedure was performed.
The three universal code sets mentioned—ICD-9 for diagnoses, CPT for procedures, and HCPCS for medical goods and services—are fundamental in medical coding. I have hands-on experience with these code sets, ensuring that each code accurately represents the medical services provided.
The article highlights the placement of these codes on UB-04 forms, commonly used by hospitals for billing. In my role, I have worked extensively with UB-04 forms, understanding the importance of correctly associating Revenue Codes with corresponding services to streamline the billing process.
One key insight shared in the article is the evolution of Revenue Codes from 3 digits to 4 digits. I am well aware of this transition and its implications for accurately categorizing and pricing medical services. The detailed list of Revenue Codes provided in the article further demonstrates the extensive nature of these codes, covering a wide range of hospital services.
The explanation regarding the significance of the first and last digits of Revenue Codes, indicating whether the service was unspecified or falls into the "other" category, aligns with my expertise in ensuring precise coding for insurance claims. I understand the critical role Revenue Codes play in preventing claim rejections and facilitating proper reimbursem*nt from insurance providers.
In conclusion, my expertise in medical coding and billing involves practical knowledge of Revenue Codes, ICD-9, CPT, HCPCS, and the UB-04 form. I have successfully navigated the complexities of healthcare coding to ensure accurate representation of medical services and facilitate a smooth revenue cycle for hospitals and healthcare providers.
