Revenue codes are 4-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill.

Is a revenue code the same as a CPT code?

Revenue codes are used along with procedure codes like CPT codes (and sometimes HCPCS codes). It is because there are various procedures that may be performed either in an emergency room or operating room. In such a case, the procedure code (CPT/HCPCS) remains the same but the revenue code varies.

What is a 250 rev code?

Q: Some of our drug charges with HCPCS J-codes are rolled into revenue code 250 (pharmacy) on the claim; we report others under revenue code 636 (drugs with detailed coding). ... CMS uses HCPCS coded drugs to establish the percentage of payment added to the ASP to cover pharmacy overhead and expenses.

WHAT IS THE REV code for MRI?

MRI procedure codes (70549, 70553, 70559, 71552, 72197, 73220, 73223, 73720, 73723, and 74183) include a MRI sequence performed without contrast media, followed by a MRI sequence performed with contrast media, and followed by MRI further sequences. The contrast medium used may be billed separately.

WHAT IS THE REV code for EKG?

UB04 Revenue Codes 0730 in section: 073X - Electrocardiogram (EKG/ECG)

014 Procedure Codes and Revenue Codes

Does rev code 370 require HCPCS?

ANSWER: Sedation is a form of anesthesia in the hospital. ... CMS wants providers to report the charge data, since anesthesia is packaged for hospitals. Whenever providers perform sedation in the hospital, a good option is to report an anesthesia charge under revenue code 370 with no HCPCS code.

What is 636 Revenue Code?

CMS uses HCPCS-coded drugs to establish the percentage of payment added to the average sales price to cover pharmacy overhead and expenses. CMS includes drugs reported under revenue code 636 in this calculation.

What is the Rev Code 278?

Revenue Code 278 – Other Implants.

Does rev code 637 require HCPCS?

The Revenue Code 637 line charge drug cost must exceed the case rate and be greater than $1,000. Use HCPCS codes that describe the services rendered.

What is a rev code in medical billing?

Basics of Revenue Code

Revenue codes are 4-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill.

Does rev code 250 require a CPT?

Your intermediary will edit to assure that HCPCS are present when the above revenue codes are billed and that they are valid HCPCS codes. ... Revenue code 250 does not require HCPCS coding.

Does rev code 272 require HCPCS?

All that said, revenue code 272 typically does not require a HCPCS code, because this revenue is used by most facilities to capture a wide variety of supply charges, many of which do not have assigned codes, and which are also usually considered incidental to some other service performed at the encounter.

Does rev code 270 require HCPCS?

Only the revenue codes listed below are recognized on the outpatient hospital claim as facility revenue codes. Do not list both a facility code and a CPT/HCPCS code. * 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.

Does rev code 278 require HCPCS?

Billed charges over $3,000.00 for revenue code 278 will require a vendor's invoice to support supplies used that correspond to the services rendered. ... If no HCPCS code is appended to revenue code 278, it will be denied as a contractual obligation to the provider.

What is revenue Code 360 used for?

Use revenue code 360 for operating room services for hospital-based ASCs. Entering specific revenue codes other than 360 will delay processing but will not affect payment. Entering "1" in form locator 46 of the UB-04 usually indicates a singular service.

What is Revenue Code 762?

Revenue Code 762 – Observation Services – Must be billed with corresponding CPT Codes 99218, 99219, 99220, 99234, 99235 or 99236. Revenue Code 762 – Observation Services – Must be billed a second time with the HCPCS Code G0378.

What is C1713?

HCPCS code C1713 is defined as “Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable).”

How are implants reimbursed?

The goal is to negotiate a carve-out fee that will cover at least the cost of the implant plus shipping and handling. Minimum Limits: Some payors use a minimum threshold plan for implant reimbursement. This allows them to only reimburse for implants that cost more than the minimum amount specified in the contract.

What is revenue Code 750?

Revenue code 490 is usually only used for an ASC, which is what I bill for, and what we use, so if you are billing for an ASC, this is correct. The 750 and 759 are described as gastrointestinal services - general classification and gastrointestinal services - other.

What is revenue Code 260?

260. Intravenous therapy: general classification.

WHAT IS THE REV code for observation?

Observation services are billed under revenue code 762, with the appropriate CPT/HCPCS code (99217-99220 and 99234-99236.)

What is the purpose of codes on claims?

Physician compensation is tied to the relative value units associated with a Current Procedural Terminology (CPT) code. Payers use coding data submitted on claims to measure population health and quality measures. Coding drives physician revenue and compensation.

What is a discharge status code?

A patient discharge status code is a two-digit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end of a billing cycle (the 'through' date of a claim).

Can 93000 be billed alone?

Billing and Coding Guide

Electrocardiograms (ECG) (e.g., CPT codes 93000, 93005, 93010) will not be separately reimbursed when submitted with a cardiac stress test (CPT code 93015), a cardiac test that includes an ECG as part of the test, or with initial hospital care.