Uniform Billing Revenue Codes
How Hospitals Group Their Charges
The UB-04 CMS-1450 claim form used by hospitals to bill third-party payers necessitates the use of revenue codes to group like categories of charges. These are four-digit codes that describe all possible categories of hospital, home health, ambulance, or other facility charges. Most claims are submitted using revenue codes at the “zero” or “sum” level, which means using codes ending in zero, which are broader categories than using the full four digits for more detail. Individual payers may require fourth-digit detail for specific categories. An example of the level of detail is category 0110, room and board, private, where the fourth digit of the code is available to indicate different room types, such as 0112-OB private, 0113-peds private, 0114-psychiatric private, and others.
Accommodation Revenue Codes
0100 |
All inclusive rate |
0110 |
Room and board, private |
Room and board, semi-private two bed | |
0130 |
Room and board, semi-private three or four beds |
0140 |
Private, deluxe |
0150 |
Room and board, ward, five or more beds |
0160 |
Other room and board (sterile environment, self-care) |
0170 |
Nursery |
0180 |
Leave of absence |
0190 |
Subacute care |
0200 |
Intensive care |
0210 |
Coronary care |
Ancillary Revenue Codes
0220 |
Special charges |
0230 |
Incremental nursing charge rate |
0240 |
All inclusive ancillary (flat rate) |
0250 |
Pharmacy |
0260 |
IV therapy |
0270 |
Medical/surgical supplies |
0280 |
Oncology |
0290 |
Durable medical equipment |
0300 |
Laboratory |
0310 |
Laboratory pathological |
0320 |
Radiology diagnostic |
0330 |
Radiology therapeutic and/or chemotherapy administration |
0340 |
Nuclear medicine |
0350 |
CT scans |
0360 |
Operating room services |
0370 |
Anesthesia |
0380 |
Blood and blood components |
0390 |
Administration, processing, and storage of blood and blood components |
0400 |
Other imaging services (mammography, ultrasound) |
0410 |
Respiratory services |
0420 |
Physical therapy |
0430 |
Occupational therapy |
0440 |
Speech therapy |
Emergency room | |
0460 |
Pulmonary function |
0470 |
Audiology |
0480 |
Cardiology |
0490 |
Ambulatory surgical care |
0500 |
Outpatient services |
0510 |
Clinic |
0520 |
Free-standing clinic |
0530 |
Osteopathic services |
0540 |
Ambulance |
0550 |
Skilled nursing |
0560 |
Home health medical social services |
0570 |
Home health aide |
0580 |
Home health other visits |
0590 |
Home health units of service |
0600 |
Home health oxygen |
0610 |
MRI or MRA (magnetic resonance imaging/angiography) |
0620 |
Medical/surgical supplies (extension of 270) |
0630 |
Pharmacy (extension of 250) |
0640 |
Home IV therapy services |
0650 |
Hospice services |
0660 |
Respite care |
0670 |
Outpatient special residence charges |
0680 |
Trauma response |
0700 |
Cast room |
0710 |
Recovery room |
0720 |
Labor and delivery room |
0730 |
Electrocardiogram (EKG/ECG) |
0740 |
Electroencephalogram (EEG) |
0750 |
Gastro-intestinal services |
0760 |
Specialty services (treatment or observation room) |
0770 |
Preventive care services (administration of vaccines) |
0780 |
Telemedicine |
0790 |
Extracorporeal shock wave lithotripsy |
0800 |
Inpatient renal dialysis |
0810 |
Acquisition of body components |
0820 |
Hemodialysis, outpatient or home |
0830 |
Peritoneal dialysis, ourpatient or home |
Continuous ambulatory peritoneal dialysis, outpatient or home | |
0850 |
Continuous cycling peritoneal dialysis, outpatient |
0880 |
Miscellaneous dialysis |
0900 |
Behavioral health services |
0910 |
Behavioral health services (extension of 900) |
0920 |
Other diagnostic services |
0930 |
Medical rehabilitation day program |
0940 |
Other therapeutic services |
0960 |
Professional fees |
0970 |
Professional fees |
0980 |
Professional fees |
0990 |
Patient convenience items |
1000 |
Behavioral health accommodations |
2100 |
Alternative therapies |
3100 |
Adult day care |
Reference
Centers for Medicare & Medicaid Services. (n.d.). Medicare claims processing manual. Pub. 100-04. Chapter 25, Section 75.4. Retrieved December 31, 2013, from http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c25.pdf