UB04/CMS1450 Revenue Codes - Group 02
- 0200 General Classification UB04 Revenue Code
- 0201 Surgical UB04 Revenue Code
- 0202 Medical UB04 Revenue Code
- 0203 Pediatric UB04 Revenue Code
- 0204 Psychiatric UB04 Revenue Code
- 0206 Intermediate ICU UB04 Revenue Code
- 0207 Burn Care UB04 Revenue Code
- 0208 Trauma UB04 Revenue Code
- 0209 Other Sub-acute Care UB04 Revenue Code
- 020X Intensive Care Unit UB04 Revenue Code
- 0210 General Classification UB04 Revenue Code
- 0211 Myocardial Infarction UB04 Revenue Code
- 0212 Pulmonary Care UB04 Revenue Code
- 0213 CCU/PULMONARY UB04 Revenue Code
- 0214 Intermediate CCU UB04 Revenue Code
- 0219 Other Coronary Care UB04 Revenue Code
- 021X Coronary Care Unit UB04 Revenue Code
- 0220 General Classification UB04 Revenue Code
- 0221 Admission Charge UB04 Revenue Code
- 0222 Technical Support Charge UB04 Revenue Code
- 0223 U.R. Service Charge UB04 Revenue Code
- 0224 Late Discharge, medically necessary UB04 Revenue Code
- 0229 Other Special Charges UB04 Revenue Code
- 022X Special Charges UB04 Revenue Code
- 0230 General Classification UB04 Revenue Code
- 0231 Nursery UB04 Revenue Code
- 0232 OB UB04 Revenue Code
- 0233 ICU (includes transitional care) UB04 Revenue Code
- 0234 CCU (includes transitional care) UB04 Revenue Code
- 0235 Hospice UB04 Revenue Code
- 0239 Other UB04 Revenue Code
- 023X Incremental Nursing Care Charges UB04 Revenue Code
- 0240 General Classification UB04 Revenue Code
- 0241 Basic UB04 Revenue Code
- 0242 Comprehensive UB04 Revenue Code
- 0243 Specialty UB04 Revenue Code
- 0249 Other All Inclusive Ancillary UB04 Revenue Code
- 024X All Inclusive Ancillary UB04 Revenue Code
- 0250 General Classification UB04 Revenue Code
- 0251 Generic Drugs UB04 Revenue Code
- 0252 Non-generic Drugs UB04 Revenue Code
- 0253 Take Home Drugs UB04 Revenue Code
- 0254 Drugs Incident to Other Diagnostic Services UB04 Revenue Code
- 0255 Drugs Incident to Radiology UB04 Revenue Code
- 0256 Experimental Drugs UB04 Revenue Code
- 0257 Nonprescription UB04 Revenue Code
- 0258 IV Solutions UB04 Revenue Code
- 0259 Other DRUGS/OTHER UB04 Revenue Code
- 025X Pharmacy (Also see 063X, an extension of 025X) UB04 Revenue Code
- 0260 General Classification UB04 Revenue Code
- 0261 Infusion Pump UB04 Revenue Code
- 0262 IV Therapy/Pharmacy Services UB04 Revenue Code
- 0263 IV Therapy/Drug/Supply/Delivery UB04 Revenue Code
- 0264 IV Therapy/Supplies UB04 Revenue Code
- 0269 Other IV Therapy UB04 Revenue Code
- 026X IV Therapy UB04 Revenue Code
- 0270 General Classification UB04 Revenue Code
- 0271 Non--sterile Supply UB04 Revenue Code
- 0272 Sterile Supply UB04 Revenue Code
- 0273 Take Home Supplies UB04 Revenue Code
- 0274 Prosthetic/Orthotic Devices UB04 Revenue Code
- 0275 Pace maker UB04 Revenue Code
- 0276 Intraocular Lens UB04 Revenue Code
- 0277 Oxygen - Take Home UB04 Revenue Code
- 0278 Other Implants UB04 Revenue Code
- 0279 Other Supplies/Devices UB04 Revenue Code
- 027X Medical/Surgical Supplies (Also see 062X, an extension of 027X) UB04 Revenue Code
- 0280 General Classification UB04 Revenue Code
- 0289 Other Oncology UB04 Revenue Code
- 028X Oncology UB04 Revenue Code
- 0290 General Classification UB04 Revenue Code
- 0291 Rental UB04 Revenue Code
- 0292 Purchase of new DME UB04 Revenue Code
- 0293 Purchase of used DME UB04 Revenue Code
- 0294 MED EQUIP/USED UB04 Revenue Code
- 0299 Other Equipment UB04 Revenue Code
- 029X Durable Medical Equipment (DME) (Other Than Rental) UB04 Revenue Code
Back to UB04/CMS1450 Revenue Codes Groups List
What are UB04 Revenue Codes?
Form CMS-1450 (UB-04)This form, also known as the UB-04, is a uniform institutional provider bill suitable for use in billing multiple third party payers. Because it serves many payers, a particular payer may not need some data elements. The National Uniform Billing Committee (NUBC) maintains lists of approved coding for the form. All items on Form CMS-1450 are described. The FI must be able to capture all NUBC-approved input data described in section 75 (of the Medicare Claims Processing Manual Chapter 25) for audit trail purposes and be able to pass all data to other payers with whom it has a coordination of benefits agreement.
CMS1450/UB04 Field: 42 - Revenue Code (Required)
The provider enters the appropriate revenue codes to identify specific accommodation and/or ancillary charges. It must enter the appropriate numeric revenue code on the adjacent line in FL 42 to explain each charge in FL 47. Additionally, there is no fixed "Total" line in the charge area. The provider must enter revenue code 0001 instead in FL 42. Thus, the adjacent charges entry in FL 47 is the sum of charges billed. This is the same line on which non-covered charges, in FL 48, if any, are summed. To assist in bill review, the provider must list revenue codes in ascending numeric sequence and not repeat on the same bill to the extent possible. To limit the number of line items on each bill, it should sum revenue codes at the "zero" level to the extent possible.
Source: Adapted from the Medicare Claims Processing Manual Chapter 25 - Completing and Processing the Form CMS-1450 Data Set
Thank you for choosing Find-A-Code, please Sign In to remove ads.