- » e-Newsletters
Tip: Understand revenue codes
Ambulatory Surgery Reimbursement Update, April 8, 2008
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. So for those payers to whom you file on UB-04 claim forms, you can (unless prohibited by your contract with the payer) break out your charges and bill for some ancillary services, like supplies.
For each line item charge listed on the claim, there must be an associated revenue code listed. However, not all charges on the claim will have an associated CPT code when you bill in this manner.
List charges for ancillary services (such as supplies) with a revenue code and a word description only.
For every CPT code listed on the UB-04 claim form, the CPT code for procedure(s) performed should be listed with a 490 revenue code for ASC surgical procedures.
Implants are listed with the 278 revenue code or with 276 for intraocular lenses (IOL) (used in cataract procedures). When revenue codes are listed on claim forms, they are listed with a leading zero, making them four digits.
There are hundreds of revenue codes, many of which are not applicable for ASCs, however, the ones most commonly used are as follows:
- Code 250 for pharmacy services
- Code 270 for medical/surgical supplies
- Code 272 for sterile supplies
- Code 274 for prosthetic/orthotic devices
- Code 276 for IOL implants (cataracts)
- Code 279 for supplies
- Code 278 for other implants
- Code 320 for x-rays (rluoroscopy)
- Code 370 for general anesthesia (bill time as units)
- Code 379 for other anesthesia (bill time as units)
- Code 490 for ASC surgical procedures
- Code 710 for recovery room services (PACU) (bill time as units)
This tip is brought to you by Ellis Medical Consulting, Inc.
- Differentiate between types of wound debridement
- CMS seeks comment on quality measures
- Note similarities and differences between HCPCS, CPT® codes
- OB services: Coding inside and outside of the package
- Fracture coding in ICD-10-CM requires greater specificity
- Complications from immobility by body system
- ICD-10-CM coma, stroke codes require more specific documentation
- Hospital offers incentives for identifying incorrect patient status
- What does case-mix index mean to you?
- What to expect when coding CAD, MI with ICD-10-CM
- Average resident salary rises
- More new physicians taking advantage of debt forgiveness program
- Medical school awards scholarships to delay student enrollment
- Three ways to safely handle, track returned meds
- Learn how to hold staff accountable in a nonpunitive culture
- Inpatient-only procedures: Accuracy helps avoid denials, ensure compliance
- HIPAA Q&A: Level of encryption needed for email
- From the nurse manager's bookshelf: Patient classification systems
- Ensure appropriate use of soft restraints, drugs
- Consider this before arming your security officers