What is Revenue Code? – E2E Medical Billing Services (2024)

What is Revenue Code? – E2E Medical Billing Services (1)

November 12, 2019Medical Coding

Revenue codes are 4-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill. The revenue code tells an insurance company whether the procedure was performed in the emergency room, operating room or another department. Hospitals run on three sets of universal codes:

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.

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. Note that you can’t report revenue codes on a CMS-1500 form, but you can report them on a UB-04. So, for those payers to whom you file on UB-04 claim forms, you can break out your charges and bill for some ancillary services, like supplies.

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 the standard for hospitals. Revenue codes go along with procedure codes. When putting them in a chargemaster, you would add the correct revenue code to the CPT code you were going to use for a particular department. It’s the use of revenue codes which allows hospitals to use the same CPT code in multiple departments because it will show which department the services were provided in.

Revenue Code	*Description*
*0001*	*Total Charges*
*001X*	*Reserved for internal payer use*
*002X*	*Health Insurance Prospective Payment System (HIPPS)*
	0020-0021 Reserved
	0022 – Skilled Nursing Facility (SNF)PPS
	0023 – Home HealthPPS
	0024 – Inpatient Rehabilitation Facility (IRF)PPS
	0025-0029 – Reserved
*003X-009X*	*Reserved*
*010X*	*All-inclusive Rate*
	0100 – All inclusive room and board plus ancillary
	0101 – All inclusive room and board
*011X*	*Room and Board Private (one bed)*
	0110 – General
	0111 – Medical/Surgical/GYN
	0112 – OB
	0113 – Pediatric
	0114 – Psychiatric
	0115 – Hospice
	0116 – Detoxification
	0117 – Oncology
	0118 – Rehabilitation
	0119 – Other
*012X*	*Room and Board Semiprivate (two beds)*
	0120 – General
	0121 – Medical/Surgical/GYN
	0122 – OB
	0123 – Pediatric
	0124 – Psychiatric
	0125 – Hospice
	0126 – Detoxification
	0127 – Oncology
	0128 – Rehabilitation
	0129 – Other
*013X*	*Room and Board (3 and 4 beds)*
	0130 – General
	0131 – Medical/Surgical/GYN
	0132 – OB
	0133 – Pediatric
	0134 – Psychiatric
	0135 – Hospice
	0136 – Detoxification
	0137 – Oncology
	0138 – Rehabilitation
	0139 – Other
*014X*	*Room and Board Deluxe Private*
	0140 – General
	0141 – Medical/Surgical/GYN
	0142 – OB
	0143 – Pediatric
	0144 – Psychiatric
	0145 – Hospice
	0146 – Detoxification
	0147 – Oncology
	0148 – Rehabilitation
	0149 – Other
*015X*	*Room and Board Ward*
	0150 – General
	0151 – Medical/Surgical/GYN
	0152 – OB
	0153 – Pediatric
	0154 – Psychiatric
	0155 – Hospice
	0156 – Detoxification
	0157 – Oncology
	0158 – Rehabilitation
	0159 – Other
*016X*	*Other Room and Board*
	0160 – General
	0164 – Sterile
	0167 – Self-care
	0169 – Other
*017X*	*Nursery*
	0170 – General
	0171 – Newborn Level I
	0172 – Newborn Level II
	0173 – Newborn Level III
	0174 – Newborn LevelIV
	0179 – Other
*018X*	*Leave of Absence*
	0180 – General
	0182 – Patience convenience – charges billable
	0183 – Therapeutic leave
	0185 – Nursing home (for hospitalization)
	0189 – Other
*019X*	*Subacute Care*
	0190 – General
	0191 – Level I
	0192 – Level II
	0193 – Level III
	0194 – LevelIV
	0199 – Other
*020X*	*Intensive Care Unit*
	0200 – General
	0201 – Surgical
	0202 – Medical
	0203 – Pediatric
	0204 – Psychiatric
	0206 – IntermediateICU
	0207 – Burn Care
	0208 – Trauma
	0209 – Other
*021X*	*Coronary Care Unit*
	0210 – General
	0211 – Myocardial Infarction
	0212 – Pulmonary Care
	0213 – Heart Transplant
	0214 – Intermediate CCU
	0219 – Other
*022X*	*Special Charges*
	0220 – General
	0221 – Admission Charge
	0222 – Technical Support Charge
	0223 –URService Charge
	0224 – Late Discharge – Medically Necessary
	0229 – Other
*023X*	*Incremental Nursing Charge*
	0230 – General
	0231 – Nursery
	0232 – OB
	0233 –ICU
	0234 – CCU
	0235 – Hospice
	0239 – Other
*024X*	*All-inclusive Ancillary*
	0240 – General
	0241 – Basic
	0242 – Comprehensive
	0243 – Specialty
	0249 – Other
*025X*	*Pharmacy*
	0250 – General
	0251 – Generic drugs
	0252 – Nongeneric drugs
	0253 – Take-home drugs
	0254 – Drugs incident to Other diagnostic services
	0255 – Drugs incident to radiology
	0256 – experimental drugs
	0257 – Nonprescription
	0258 –IVsolutions
	0259 – Other
*026X*	*IVTherapy*
	0260 – General
	0261 – Infusion pump
	0262 – Pharmacy services
	0263 – Drug/supply delivery
	0264 – Supplies
	0269 – Other
*027X*	*Medical/Surgical Supplies and Devices*
	0270 – General
	0271 – Nonsterile
	0272 – Sterile
	0273 – Take-home supplies
	0274 – Prosthetic/orthotic devices
	0275 – Pacemaker
	0276 – Intracular lens
	0277 – Take-home oxygen
	0278 – Other implants
	0279 – Other
*028X*	*Oncology*
	0280 – General
	0289 – Other
*029X*	*Durable Medical Equipment (Other than Renal)*
	0290 – General
	0291 – Rental
	0292 – Purchase of newDME
	0293 – Purchase of usedDME
	0294 – Supplies/Drugs forDME
	0299 – Other
*030X*	*Laboratory*
	0300 – General
	0301 – Chemistry
	0302 – Immunology
	0303 – Renal patient (home)
	0304 – Nonroutine dialysis
	0305 – Hematology
	0306 – Bacteriology and Microbiology
	0307 – Urology
	0309 – Other
*031X*	*Laboratory Pathology*
	0310 – General
	0311 – Cytology
	0312 – Histology
	0314 – Biopsy
	0319 – Other
*032X*	*Radiology Diagnostic*
	0320 – General
	0321 – Angiocardiography
	0322 – Arthrography
	0323 – Arteriography
	0324 – Chest X-ray
	0329 – Other
*033X*	*Radiology Therapeutic and/of Chemotherapy Administration*
	0330 – General
	0331 – Chemotherapy administration – injection
	0332 – Chemotherapy administration – oral
	0333 – Radiation therapy
	0335 – Chemotherapy administration –IV
	0339 – Other
*034X*	*Nuclear Medicine*
	0340 – General
	0341 – Diagnostic
	0342 – Therapeutic
	0343 – Diagnostic radiopharmaceuticals
	0344 – Therapeutic radiopharmaceuticals
	0349 – Other
*035X*	*CT Scan*
	0350 – General
	0351 – Head scan
	0352 – Body scan
	0359 – Other
*036X*	*Operating Room Services*
	0360 – General
	0361 – Minor surgery
	0362 – Organ transplant – other than kidney
	0367 – Kidney transplant
	0369 – Other
*037X*	*Anesthesia*
	0370 – General
	0371 – Incident to radiology
	0372 – incident to Other Diagnostic services
	0374 – Acupuncture
	0379 – Other
*038X*	*Blood and Blood Products*
	0380 – General
	0381 – Packed red cells
	0382 – Whole blood and blood products
	0383 – Plasma
	0384 – Platelets
	0385 – Leukocytes
	0386 – Other components
	0387 – Other derivatives (cryoprecipitates)
	0389 – Other
*039X*	*Administration, Processing and Storage for Blood and Blood Components*
	0390 – General
	0391 – Administration (e.g., transfusions)
	0392 – Processing and storage
	0399 – Other processing and storage
*040X*	*Other Imaging Services*
	0400 – General
	0401 – Diagnostic mammography
	0402 – Ultrasound
	0403 – Screening mammography
	0404 – Positron Emission Tomography
	0409 – Other
*041X*	*Respiratory Services*
	0410 – General
	0412 – Inhalation services
	0413 – Hyperbaric oxygen therapy
	0419 – Other
*042X*	*Physical Therapy*
	0420 – General
	0421 – Visit charge
	0422 – Hourly charge
	0423 – Group rate
	0424 – Evaluation or reevaluation
	0429 – Other
*043X*	*Occupational Therapy*
	0430 – General
	0431 – Visit charge
	0432 – Hourly charge
	0433 – Group rate
	0434 – Evaluation or reevaluation
	0439 – Other
*044X*	*Speech Therapy Language Pathology*
	0440 – General
	0441 – Visit charge
	0442 – Hourly charge
	0443 – group rate
	0444 – Evaluation or reevaluation
	0449 – Other
*045X*	*Emergency Room*
	0450 – General
	0451 –EMTALAemergency medical screening services
	0452 –ERbeyondEMTALAscreening
	0456 – Urgent care
	0459 – Other
*046X*	*Pulmonary Function*
	0460 – General
	0469 – Other
*047X*	*Audiology*
	0470 – General
	0471 – Diagnostic
	0472 – Treatment
	0479 – Other
*048X*	*Cardiology*
	0480 – General
	0481 – Cardiac cath lab
	0482 – Stress test
	0483 – Echocardiology
	0489 – Other
*049X*	*Ambulatory Surgical Care*
	0490 – General
	0499 – Other
*050X*	*Outpatient Services*
	0500 – General
	0509 – Other
*051X*	*Clinic*
	0510 – General
	0511 – Chronic pain center
	0512 – Dental clinic
	0513 – Psychiatric clinic
	0514 – OB/GYN clinic
	0515 – Pediatric clinic
	0516 – Urgent care clinic
	0517 – Family practice clinic
	0519 – Other
*052X*	*Freestanding Clinic*
	0520 – General
	0521 – Clinic visit by member toRHC/FQHC
	0522 – Home visit byRHC/FQHCpractitioner
	0523 – Family practice clinic
	0524 – Visit byRHC/FQHCpractitioner to member in a Part A covered stay inSNF
	0525 – Visit byRHC/FQHCpractitioner to member in a stay not covered by Part A in a
	SNF,NFor ICFMRor other residential facility
	0526 – Urgent care clinic
	0527 – Visiting nurse services to member’s home in a home health shortage area
	0528 – Visit byRHC/FQHCpractitioner to other non-RHC/FQHCsite (e.g., scene of accident)
	0529 – Other
*053X*	*Osteopathic Services*
	0530 – General
	0531 – Osteopathic therapy
	0539 – Other
*054X*	*Ambulance*
	0540 – General
	0541 – Supplies
	0542 – Medical transport
	0543 – Heart mobile
	0544 – Oxygen
	0545 – Air ambulance
	0546 – Neonatal ambulance
	0547 – Pharmacy
	0548 –EKGtransmission
	0549 – Other
*055X*	*Skilled Nursing*
	0550 – General
	0551 – Visit charge
	0552 – Hourly charge
	0559 – Other
*056X*	*Home Health Medical Social Services*
	0560 – General
	0561 – Visit charge
	0562 – Hourly charge
	0569 – Other
*057X*	*Home Health Aide*
	0570 – General
	0571 – Visit charge
	0572 – Hourly charge
	0579 – Other
*058X*	*Home Health Other Visits*
	0580 – General
	0581 – Visit charge
	0582 – Hourly charge
	0583 – Assessment
	0589 – Other
*059X*	*Home Health Units of Service*
	0590 – General
*060X*	*Home Health Oxygen*
	0600 – General
	0601 – Stat/Equip/Supply or contents
	0602 – Stat/Equip/Supply Under 1LPM
	0603 – Stat/Equip Over 4LPM
	0604 – Portable Add-on
	0609 – Other
*061X*	*Magnetic Resonance Technology (MRT)*
	0610 – General
	0611 – Brain/brain stem
	0612 – Spinal cord/spine
	0614 – Other MRI
	0615 – Head and neck
	0616 – Lower extremities
	0618 – Other MRA
	0619 – Other MRT
*062X*	*Medical/Surgical Supplies – Extension of 027X*
	0621 – Incident to Radiology
	0622 – Incident to Other Diagnostic services
	0623 – Surgical Dressings
	0624 –FDAinvestigational devices
*063X*	*Pharmacy – Extension of 025X*
	0631 – Single source drug
	0632 – Multiple source drug
	0633 – Restrictive prescription
	0634 – Erythropoietin (EPO) less than 10,000 units
	0635- Erythropoietin (EPO) 10,000 or more units
	0636 – Drugs requiring detailed coding
	0637 – Self-administerable drugs
*064X*	*HomeIVTherapy Services*
	0640 – General
	0641 – Nonroutine nursing, central line
	0642 –IVsite care, central line
	0643 –IVstart/care, peripheral line
	0644 – Nonroutine nursing, peripheral line
	0645 – Training patient/caregiver, central line
	0646 – Training disabled patient, central line
	0647 – Training patient/caregiver, peripheral line
	0648 – Training disabled patient, peripheral line
	0649 – Other
065X	*Hospice Service*
	0650 – General
	0651 – Routine home care
	0652 – Continuous home care
	0655 – Inpatient respite care
	0656 – General inpatient care (nonrespite)
	0657 – Physician services
	0658 – Hospice room and board – nursing facility
	0659 – Other
*066X*	*Respite Care*
	0660 – General
	0661 – Hourly charge/nursing
	0662 – Hourly charge/aide/homemaker/companion
	0663 – daily respite charge
	0669 – Other
*067X*	*Outpatient Special Residence Charges*
	0670 – General
	0671 – Hospital owned
	0672 – Contracted
	0679 – Other
*068X*	*Trauma Response*
	0681 – Level I
	0682 – Level II
	0683 – Level III
	0684 – LevelIV
	0689 – Other
*069X*	*Reserved*
070X	*Cast Room*
	0700 – General
*071X*	*Recovery Room*
	0710 – General
*072X*	*Labor Room/Delivery*
	0720 – General
	0721 – Labor
	0722 – Delivery
	0723 – Circumcision
	0724 – Birthing center
	0729 – Other
*073X*	*EKG/ECGElectrocardiogram*
	0730 – General
	0731 – Holter monitor
	0732 – Telemetry
	0739 – Other
*074X*	*EEG Electroencephalogram*
	0740 – General
*075X*	*Gastrointestinal Services*
	0750 – General
*076X*	*Specialty Services*
	0760 – General
	0761 – Treatment room
	0762 – Observation hours
	0769 – Other
*077X*	*Preventive Services*
	0770 – General
	0771 – Vaccine administration
*078X*	*Telemedicine*
	0780 – General
*079X*	*Extra-Corporeal Shock Wave Therapy (formerly Lithotripsy)*
	0790 – General
*080X*	*Inpatient Renal Dialysis*
	0800 – General
	0801 – Inpatient hemodialysis
	0802 – Inpatient peritoneal (non-CAPD)
	0803 – Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)
	0804 – Inpatient Continuous Cycling Peritoneal Dialysis (CCPD)
	0809 – Other
*081X*	*Acquisition of Body Components*
	0810 – General
	0811 – Living donor
	0812 – Cadaver donor
	0813 – Unknown donor
	0814 – Unsuccessful organ search – donor bank charges
	0819 – Other
*082X*	*Hemodialysis – Outpatient or Home*
	0820 – General
	0821 – Composite or other rate
	0822 – Home supplies
	0823 – Home equipment
	0824 – Maintenance/100%
	0825 – Support Services
	0829 – Other
*083X*	*Peritoneal Dialysis – Outpatient or Home*
	0830 – General
	0831 – Composite or other rate
	0832 – Home supplies
	0833 – Home equipment
	0834 – Maintenance/100%
	0835 – Support Services
	0839 – Other
*084X*	*Continuous Ambulatory Peritoneal Dialysis (CAPD)- Outpatient or Home*
	0840 – General
	0841 – Composite or other rate
	0842 – Home supplies
	0843 – Home equipment
	0844 – Maintenance/100%
	0845 – Support Services
	0849 – Other
*085X*	*Continuous Cycling Peritoneal Dialysis (CCPD) – Outpatient or Home*
	0850 – General
	0851 – Composite or other rate
	0852 – Home supplies
	0853 – Home equipment
	0854 – Maintenance/100%
	0855 – Support Services
	0859 – Other
*086X*	*Magnetoencephalography*
	0860 – General
	0861 – MEG
*087X*	*Reserved*
*088X*	*Miscellaneous Dialysis*
	0880 – General
	0881 – Ultrafiltration
	0882 – Home dialysis aid visit
	0889 – Other
*089X*	*Reserved*
*090X*	*Behavioral Health Treatments/Services (also see 091X, and extension of 090X)*
	0900 – General
	0901 – Electroshock
	0902 – Milieu therapy
	0903 – Play therapy
	0904 – Activity therapy
	0905 – Intensive outpatient services – psychiatric
	0906 – Chemical dependency
	0907 – Community behavioral health program – day treatment
*091X*	*Behavioral Health Treatments/Services – Extension of 090X*
	0911 – Rehabilitation
	0912 – Partial hospitalization – less intensive
	0913 – Partial hospitalization – intensive
	0914 – Individual therapy
	0915 – Group therapy
	0916 – Family therapy
	0917 – Biofeedback
	0918 – Testing
	0919 – Behavioral health treatments
*092X*	*Other Diagnostic Services*
	0920 – General
	0921 – Peripheral vascular lab
	0922 – Electromyelogram
	0923 – Pap smear
	0924 – Allergy test
	0925 – Pregnancy test
	0929 – Other
*093X*	*Medical Rehabilitation Day Program*
	0931 – Half day
	0932 – Full day
*094X*	*Other Therapeutic Services – See also 095X*
	0940 – General
	0941 – Recreational
	0942 – Education/training
	0943 – Cardiac rehabilitation
	0944 – Drug rehabilitation
	0945 – Alcohol rehabilitation
	0946 – Complex medical equipment – routine
	0947 – Complex medical equipment – ancillary
	0948 – Pulmonary rehabilitation
	0949 – Other
*095X*	*Other Therapeutic Services (Extension of 094X)*
	0951 – Athletic training
	0952 – Kinesiotherapy
*096X*	*Professional Fees*
	0960 – General
	0961 – Psychiatric
	0962 – Ophthalmology
	0963 – Anesthesiologist (MD)
	0964 – Anesthesiologist (CRNA)
	0969 – Other
*097X*	*Professional Fees (Extension of 096X)*
	0971 – Laboratory
	0972 – Radiology – diagnostic
	0973 – Radiology – therapeutic
	0974 – Nuclear medicine
	0975 – Operating room
	0976 – Respiratory therapy
	0977 – Physical therapy
	0978 – Occupational therapy
	0979 – Speech pathology
*098X*	*Professional Fees (Extension of 096X and 097X)*
	0981 – Emergency room
	0982 – Outpatient services
	0983 – Clinic
	0984 – Medical social services
	0985 –EKG
	0986 – EEG
	0987 – Hospital visit
	0988 – Consultation
	0989 – Private-duty nurse
*099X*	*Patient Convenience Items*
	0990 – General
	0991 – Cafeteria/guest tray
	0992 – Private linen service
	0993 – Telephone/telegraph
	0994 – TV/radio
	0995 – Nonpatient room rentals
	0996 – Late discharge charge
	0997 – Admission kits
	0998 – Beauty shop/barber
	0999 – Other
*100X*	*Behavioral Health Accommodations*
	1000 – General
	1001 – Residential treatment – psychiatric
	1002 – Residential treatment – chemical dependency
	1003 – Supervised living
	1004 – Halfway House
	1005 – Group Home
*101X-209X*	*Reserved*
*210X*	*Alternative Therapy Services*
	2100 – General
	2101 – Acupuncture
	2102 – Acupressure
	2103 – Massage
	2104 – Reflexology
	2105 – Biofeedback
	2106 – Hypnosis
	2109 – Other
*211x – 300X*	*Reserved*
*310X*	*Adult Care*
	3101 – adult daycare, medical and social – hourly
	3102 – Adult daycare, social – hourly
	3103 – Adult daycare, medical and social – daily
	3104 – Adult daycare, social – daily
	3105 – Adult foster care – daily
	3109 – Other
*311X-999X*	*Reserved*

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What is Revenue Code? – E2E Medical Billing Services (2024)

FAQs

What is the revenue code? ›

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.

Get More Info Here ›

What claims use revenue codes? ›

Revenue codes are used in hospital billing. The list of revenue codes for medical billing conveys to the insurance payer either where the patient was or when they received treatment or what type of equipment a patient might have received.

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What is the revenue code for 99213? ›

CPT® code 99213: Established patient office or other outpatient visit, 20-29 minutes. As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.

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What is a revenue code and what is it used for? ›

Revenue codes means a method of coding used by hospitals or health care systems to identify the department in which medical service was rendered to the patient or the type of item or equipment used in the delivery of medical services.

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What is revenue code 762? ›

Revenue Code 762 – Observation Services – Must be billed with corresponding CPT Codes 99218, 99219, 99220, 99234, 99235 or 99236. Revenue Code 762 – Observation Services – Must be billed a second time with the HCPCS Code G0378.

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Can we use revenue code to bill the medical insurance company? ›

The use of revenue code is simply to group similar types of charges onto one line in the CMS-1450 form. Without the revenue code mentioned in the UB-04 form, the insurance payer will not pay the medical claim. Revenue codes are used along with procedure codes like CPT codes (and sometimes HCPCS codes).

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How are revenue codes determined? ›

The National Uniform Billing Committee assigns revenue codes at the national level. These are shown in the UB-92 manual. Some revenue codes, including all codes ending in "9", are assigned by the state uniform billing committees. These should be translated to the general category ending in zero.

Is revenue code same as procedure code? ›

Revenue codes indicate to the type of service that you are billing for; revenue codes are 3-digit codes, and those revenue codes must match up with specific procedure codes to designate what services were rendered.

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What is the revenue cycle for medical billing? ›

Revenue cycle starts with the appointment or hospital visit and ends when the provider or hospital gets paid fully for the services provided. The seven steps of revenue cycle include preregistration, registration, charge capture, claim submission, remittance processing, insurance follow-up and patient collections.

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What are the 3 main concepts used in revenue management? ›

The discipline of revenue management combines data mining and operations research with strategy, understanding of customer behavior, and partnering with the sales force.

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What is revenue Code 022? ›

the claim with revenue code 0022. This code indicates that this claim is being paid under SNF PPS. This revenue code can appear on a claim as often as necessary to indicate different HIPPS rate code(s) and assessment periods.

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What is revenue Code 120? ›

Description. 120. Room and board. 121. Medical/Surgical/Gyn.

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What is revenue Code 114? ›

114 * Room and Board – Private, Psychiatric. 117. Room and Board – Private, Oncology.

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What are procedure codes for billing? ›

“Procedure” code is a catch-all term for codes used to identify what was done to or given to a patient (surgeries, durable medical equipment, medications, etc.). Understanding and identifying the codes relevant to one's study question is a key part of analyzing claims data.

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What codes are used for hospital billing? ›

There are three types of medical billing codes used in the U.S. healthcare system:

International Classification of Diseases (ICD) codes.
Current Procedure Terminology (CPT) codes.
Healthcare Common Procedure Coding system (HCPCS) codes.

29 Oct 2021

What is the fourth digit in the revenue code? ›

The first digit is a leading zero. The fourth digit defines the frequency of the bill for processional claims. The leading zero should not be reported on electronic claims. Refer to Attachment B for valid codes.

What is revenue code 510? ›

The revenue code 510 is for the facility costs including the use of the space, materials and staff.

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What is revenue code 23? ›

Revenue Code 0023 indicates that the billing is for services under the Home Health Prospective Payment System (HHPPS).

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What is revenue code 721? ›

721 - Admit Through Discharge Claim - This code is used for a bill encompassing an entire course of outpatient treatment for which the provider expects payment from the payer. 722 - Interim - First Claim - This code is used for the first of an expected series of payment bills for the same course of treatment.

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What are 3 different types of billing systems in healthcare? ›

There are three basic types of systems: closed, open, and isolated. Medical billing is one large system part of the overarching healthcare network. The healthcare network includes everything from medical billing to best practices for patient care, health institutions, and private practices.

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Can a Biller bill without a CPT code? ›

In medical billing, an unlisted code is used to report a service or procedure that does not have a specific Current Procedural Terminology (CPT) code. Reimbursem*nt for these services can be nuanced and complex, but can be navigated with some basic understanding.

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Why is medical billing important in revenue generation process? ›

Role of Medical Billing in RCM :

It plays a crucial role in generating revenue to the health care provider by extending their services back and forth. Medical billing delivers a smoother and swifter service to the health care providers by means of Revenue Cycle Management.

What are UB04 revenue codes? ›

What are UB04 Revenue Codes? This form, also known as the UB-04, is a uniform institutional provider bill suitable for use in billing multiple third party payers. Because it serves many payers, a particular payer may not need some data elements.

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Do revenue codes require HCPCS? ›

Packaged Revenue Codes

Any other revenue codes that are billable on a hospital outpatient claim must contain a HCPCS code in order to assure payment under OPPS. Return to provider (RTP), claims which contain revenue codes that require a HCPCS code when no HCPCS code is shown on the line.

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How do hospitals recognize revenue? ›

A service is transferred and revenue recognition occurs over a period of time if the patient simultaneously receives and consumes the benefits provided by the entity's performance as the entity performs, such as during chemotherapy.

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What are the 2 types of codes in CPT? ›

There are various types of CPT codes:

Category I: These codes have descriptors that correspond to a procedure or service. ...
Category II: These alphanumeric tracking codes are supplemental codes used for performance measurement.

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Are revenue codes required on UB04? ›

Per NUBC, outpatient UB-04 claims must be billed with both a revenue code and a CPT or HCPCS code. A revenue code must be assigned for each line item. If multiple CPT or HCPCS are necessary to reflect multiple, distinct, or independent visits with the same revenue code, repeat the revenue code as required.

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What is the revenue code used in an ASC? ›

ASCs use the CMS-1500 or the UB04 form for claiming. Criteria for claiming are: Bill to be used (TOB) 0831, identical from and through dates to be mentioned in form locator (FL) 6, procedures should use revenue codes 0490 or 0360, CPT-4 code for a procedure should be entered in FL 44, and National Drug codes must be ...

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What are the 5 denials? ›

Top 5 List of Denials In Medical Billing You Can Avoid

#1. Missing Information. You'll trigger a denial if just one required field is accidentally left blank. ...
#2. Service Not Covered By Payer. ...
#3. Duplicate Claim or Service. ...
#4. Service Already Adjudicated. ...
#5. Limit For Filing Has Expired.

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What is medical revenue service? ›

What Is Medical Revenue Service? Medical Revenue Services help provider groups, hospitals, and different practices with revenue management. They all need these services because they specialize in taking care of patients and not collecting money from insurance carriers or said, patients.

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How many steps are in medical billing? ›

The medical insurance billing process may sound overly complicated, but in reality, it constitutes eight simple steps. These steps include: Registration. Establishment of Financial Responsibility for Patient Visit.

What are 4 types of revenue? ›

Rent revenue. Dividend revenue. Interest revenue. Contra revenue (sales return and sales discount)

What are the two types of revenues? ›

Revenue can be divided into operating revenue—sales from a company's core business—and non-operating revenue which is derived from secondary sources. As these non-operating revenue sources are often unpredictable or nonrecurring, they can be referred to as one-time events or gains.

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What are the three examples of revenue? ›

The three examples of revenue are:

Rent received.
Amount received from one time sale of an asset.
Interest received from bank accounts.

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What are the five key areas for revenue cycle improvement? ›

Five steps to improve a practice's revenue cycle management...

Focus on the patient. ...
Consolidate systems. ...
Focus on collecting payments early. ...
Give patients alternative ways to pay. ...
Focus on improving systems on the back-end.

22 May 2017

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What is medical billing interview questions? ›

Commonly Asked Medical Billing Interview Questions

In which medical departments do you have billing experience? ...
What medical records software have you used in the past? ...
Can you describe the process of medical billing? ...
What are the common challenges you may face in medical billing?

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4 May 2022

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What is the most important step of revenue cycle? ›

The first and most vital step in the revenue cycle process, preregistration allows the medical practice to capture demographic information, insurance information and eligibility in real time through a clearing house, often while the patient is still on the phone.

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What is revenue code 180? ›

0180 in section: 018X - Leave of Absence.

What is revenue Code 522? ›

➢ Provider-Based (Hospital-Based) rural health clinics must identify services provided on the UB-92 form by using Revenue code 521 for rural health services, Revenue code 522 for home visit services by a practitioner and Revenue code 527 for Visiting Nurse services to a member's home when in a home health storage area.

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What is revenue Code 0444? ›

0442 - Hourly charge. 0443 - Group rate. 0444 - Evaluation or reevaluation. 0449 - Other. 045X.

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What is revenue code 571? ›

codes for revenue code 559 on front. 561. Medical Social Services - Visit Charge. 571. Home Health Aide - Visit Charge.

What is revenue code 160? ›

016X - Other Room & Board (Medical or General)

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What is revenue code 169? ›

Revenue code 169 must be used when billing for accommodation charges for administrative days. Claims containing a mixture of administrative days and any other revenue code will be denied.

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What is revenue code 193? ›

Revenue Code & Description. (Corresponding Level of Care) 193 = Pervasive Level of Care.

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What is revenue code 278? ›

Revenue code 278 is for implanted devices, and it's pretty common for these to have an associated HCPCS code, and there are unlisted codes (e.g. L8699) available for those items that don't have specific code.

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What is revenue code 333? ›

If a patient receives radiation therapy (billed under revenue code 333), an outpatient consultation, clinical laboratory services and a CT scan on the same day, the hospital reports the radiation therapy on the monthly claim with the other repetitive services and reports the outpatient consultation, CT scan on a ...

Is a revenue code A four digit code? ›

Revenue codes are 3 or 4 digit numbers that hold information about a patient's treatment or services performed by health care providers. These are universal codes that are added to a hospital bill and are mandatory for a medical professional in order to submit a clean claim.

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What is revenue code 0300? ›

0300 General Classification 0301 Chemistry 0302 Immunology 0304 Non-Routine Dialysis 0305 Hematology 0306 Bacteriology and Microbiology 0307 Urology Note: The lab revenue codes require an HCPCS code. 031X. LABORATORY-PATHOLOGICAL. Charges for diagnostic and routine laboratory tests in tissues and culture.

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Why are revenue codes used? ›

A revenue code is used in UB-04 or CMS-1450 to indicate the department or place in which a procedure or treatment is performed—an emergency room, operating room, or some other department. This helps the insurance companies to identify the type, place, and supplies used for a procedure while making the payment.

What is revenue code 0444? ›

0442 - Hourly charge. 0443 - Group rate. 0444 - Evaluation or reevaluation. 0449 - Other. 045X.

What is the most used 4 digit code? ›

The most common four-digit PINs, according to the study, are 1234, 0000, 2580 (the digits appear vertically below each other on the numeric keypad), 1111 and 5555.

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What is revenue code 022? ›