What is the Revenue Code in Medical Billing (2024)

FAQs

What is a revenue code? ›

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.

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.

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.

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.

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.

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.

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.

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

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

The collection processing and storage services are reported using Revenue Code 0390 or 0391 with the appropriate blood product code, the number of units transfused and the HCPCS modifier BL. Whenever there is a charge for the blood, there must be a corresponding charge for processing.

What is revenue code 0171? ›

0171 Newborn–Level I - This level reflects routine care of apparently normal full-term or preterm neonates (considered to be newborn nursery).

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.

Revenue codes are typically 3-digit or 4-digit numbers that are used on hospital bills to help insurance carriers identify different type of services, the type of supplies used and the department in which services were rendered to the patient.

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

Instruct your hospitals to report implantable orthotic and prosthetic devices and implantable durable medical equipment (DME) under another revenue code such as 0278 – other implants.

Bill Types requiring revenue codes with a corresponding CPT®/HCPCS include 012x, 013x, 014x, 074x, 075x, 076x and 083x. Multiple lines of the same revenue codes are required to represent different CPT® or HCPCS. Revenue codes with modifiers are not reimbursable when a HCPCS or CPT® code is not submitted.

Coding and Revenue Cycle Management is the process that facilities use to manage the administrative and financial functions associated with patient registration, benefit verification, coding, claims processing, and payment and collection, all integral aspects of revenue generation.

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.

A cost center is a division or unit within a hospital (e.g., radiology, emergency room, pathology). EXCEPTION: Revenue center code 0001 represents the total of all revenue centers included on the claim. Source: NCH. Revenue Center Codes are Copyrighted by the American Hospital Association.

0180 in section: 018X - Leave of Absence.

What are the 2 types of codes in CPT? ›

Revenue code 250 does not require HCPCS coding. However, drugs that can be self-administered are not covered by Medicare. The professional services listed below when provided in a hospital outpatient department are separately covered and paid as the professional services of physicians and other practitioners.

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

* Revenue code 270 should be reported only once on the outpatient claim. It is to be reported for medical or surgical supplies or both combined. Observation room services.

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 ...

Codes 00100-01999 should not be billed by the facility under revenue code 0370 - Revenue code 0370 should be used for billing charges associated with the technical component of the anesthesia services or sedation services.

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

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

➢ 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.

There are several ways revenue code 250 can be used for billing outpatient medications. The first pertains to billing for a covered medication which does not have a valid HCPCS or CPT code. In this instance, revenue code 250 may be billed without a corresponding code.

What is revenue code 720? ›

0720 in section: 072X - Labor Room/Delivery.

IV therapy should be billed using revenue code 260 and HCPCS code Q0081 with modifier code 22. Therapies may include, but are not limited to, the following: Hydration therapy (Please indicate the number of liters and whether the hydration solution contains additives.) Antibiotic, antiviral and antifungal therapy.

RHC Revenue Codes

0524 - Visit by RHC practitioner to a member in a covered Part A stay at a Skilled Nursing Facility (SNF) 0525 - Visit by RHC practitioner to a member in a SNF (not in a covered Part A stay) or NF or ICF MR or other residential facility.

722 - Interim - First Claim - This code is used for the first of an expected series of payment bills for the same course of treatment. 723 - Interim - Continuing Claim - This code is used when a payment bill for the same course of treatment is submitted and further bills are expected to be submitted later.

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.

Revenue code 881 is reimbursable only for dates of service on which no other dialysis services were provided. Additionally, providers are limited to one unit of service per date of service for these 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.

Why is revenue important? Revenue is what keeps your business alive. Beyond being a lifeline, revenue can give you key insights into your business. If you want to increase your business profits, you need to increase your revenue.

119. Room and Board – Private, Other. 121. Room and Board – Semiprivate 2 Bed, Medical/Surgical/Gynecological.

What is revenue Code 159? ›

Room and Board – Ward (Medical or General), Rehabilitation. 159. Room and Board – Ward, Other.

Birthing Center Facility Billing(Revenue code 724)