Revenue code

Revenue codes belong to the institutional claim. Facilities report them on the UB-04 or the 837I. Each code has four positions, and an x in the last position of a code range means the final digit can vary, so 042x is the physical therapy family. The National Uniform Billing Committee maintains the code set through its Official UB-04 Data Specifications Manual, which it describes as the only official source of UB data.

On the paper form, the code goes in form locator 42, on the same line as the charge it explains. Medicare’s instructions ask for codes in ascending numeric order, without repeating a code on the same bill where possible, summed at the zero level when that keeps the line count down, with a final 0001 line for total charges. Some revenue codes do more than label a charge. In Medicare’s prospective payment systems, one revenue code per system carries the HIPPS payment code: 0022 for skilled nursing facilities, 0023 for home health agencies and 0024 for inpatient rehabilitation facilities.

The mistake is a revenue code that does not fit the service or the provider type on its line. On a home health claim, every visit under 042x, 043x, 044x, 055x, 056x or 057x has to be its own line with a HCPCS code, a date and its units, and a period claim with no visit charges at all is returned to the agency. Keep the chargemaster’s revenue codes mapped to the services each one may carry, and review that map whenever the payer’s code lists change.