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  • Revenue Codes

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Medicare UB04 Revenue Codes Revised August 2010 0001 Total Charge 002X HI Prosp Paymt System HIPPS 2 SNF PPS (RUG) 3 HH PPS (HRG) 4 IRF PPS (CMG) 0100 AllInclusive Room & Board/Anc 1 AllInclusive.

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How to fill out the Revenue Codes online

The Revenue Codes form is essential for accurately categorizing healthcare services for billing and reimbursement. This guide provides a clear, step-by-step approach to completing the Revenue Codes online, ensuring you have the necessary information at your fingertips.

Follow the steps to successfully complete your Revenue Codes form.

  1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
  2. Begin with Section 0001, labeled 'Total Charge.' Enter the total amount being billed for the services rendered.
  3. Proceed to Section 002X, which specifies the payment system. Select the appropriate option from the dropdown that corresponds to the payment methodology applicable to your service.
  4. Next, fill out the room and board sections from 0100 to 0150. Choose the correct type of accommodation provided, and ensure to specify additional details as necessary, such as medical/surgical type.
  5. Continue with Section 0200 for Intensive Care services. Input the relevant details based on the patient's needs, selecting from surgical, medical, or other care types.
  6. Throughout the form, ensure that you select the most applicable charges from the extensive list of categories provided. This will include services such as pharmacy, therapy, and laboratory services.
  7. Once all sections are completed, review your entries for accuracy. It's important to double-check coding to avoid errors that could delay processing.
  8. Finally, you can save any changes made, download the form for your records, or print it out if necessary. You can also share it with relevant stakeholders involved in the billing process.

Start completing your Revenue Codes form online to streamline your billing process today.

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All electronic claims submitted by an outpatient facility provider or hospital must include a supporting HCPCS or CPT code with a revenue code.

Revenue codes are three-digit codes that affect reimbursement and represent the services provided by the ASC facility for a payer. ... When revenue codes are listed on claim forms, they are listed with a leading zero, making them four digits.

122. Room & Board: Semi-Private 2 Beds OB. 132. Room & Board: Semi-Private; 3 and 4 Beds OB. 152.

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.

Outpatient services, including ASC services, rendered in an all inclusive method rate provider will be billed using the 85X type of bill. Revenue code 510 should be on the bill with visits indicated in the units field and the dollar amount in the charges field.

Facilities bill for supplies used to administer drugs with revenue code 0270, Medical/Surgical Supplies. The number of administrations is shown in the units field.

Examples of Revenue Code An easy example to use here would be to match up CPT code 99282, which is for an emergency room visit of low to moderate severity, and revenue code 0450, which stands for the emergency room. ... It could be done in a treatment room; that would be revenue code 0761.

ANCILLARY REVENUE CODES (022X -099X) 022X Special Charges Charges incurred during an inpatient stay or on a daily basis for certain services.

Revenue codes are three-digit codes that affect reimbursement and represent the services provided by the ASC facility for a payer. Note that you can't report revenue codes on a CMS-1500 form, but you can report them on a UB-04.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232