|Revenue Codes, Descriptions, and Charges|
All medical services provided to patients, whether inpatients or outpatients, have costs associated with them. This chapter covers form locators 42-49, lines 1-23, which are used for recording and totaling the cost of each service received for the billing period reflected on the claim (see Figure 12.1). To help the payer understand what services were received by the patient, how much each service costs, and when each service was received, the billing provider must fill in FLs 42-49 carefully and precisely.
According to the current revenue code system defined by the National Uniform Billing Committee (NUBC) for the UB-04 claim form, every service is assigned a revenue code and description. Each revenue code and corresponding description reflects an item, accommodation, or service that is billable by providers. Because revenue codes and descriptions provide the exact details of the service received, they play a key role in determining the final reimbursement amount.
The original NUBC revenue code system used three-digit codes numbered from 001 to 999. To accommodate the need for more codes, the coding system was expanded to a four-digit system. A leading zero was added to the original three-digit codes to make them four-digit codes.
Revenue codes are grouped into major categories, such as Room and BoardPrivate (011X), Pharmacy (025X), and Physical Therapy (042X). This chapter lists all revenue codes. Descriptions and usage guidelines are provided for the major revenue code categories. Billing tips help explain revenue codes that are often reported incorrectly. For quick reference, Appendix A contains a numerical list of all revenue codes as well as an alphabetical list of selected codes.