UB04/CMS1450 Revenue Codes - Group 03
- 0300 General Classification UB04 Revenue Code
- 0301 Chemistry UB04 Revenue Code
- 0302 Immunology UB04 Revenue Code
- 0303 Renal Patient (Home) UB04 Revenue Code
- 0304 LAB/RENAL HOME UB04 Revenue Code
- 0305 Hematology UB04 Revenue Code
- 0306 Bacteriology & Microbiology UB04 Revenue Code
- 0307 Urology UB04 Revenue Code
- 0309 Other Laboratory UB04 Revenue Code
- 030X Laboratory UB04 Revenue Code
- 0310 General Classification UB04 Revenue Code
- 0311 Cytology UB04 Revenue Code
- 0312 Histology UB04 Revenue Code
- 0314 Biopsy UB04 Revenue Code
- 0319 Other UB04 Revenue Code
- 031X Laboratory Pathological UB04 Revenue Code
- 0320 General Classification UB04 Revenue Code
- 0321 Angiocardiography UB04 Revenue Code
- 0322 Arthrography UB04 Revenue Code
- 0323 Arteriography UB04 Revenue Code
- 0324 Chest X-Ray UB04 Revenue Code
- 0329 Other UB04 Revenue Code
- 032X Radiology - Diagnostic UB04 Revenue Code
- 0330 General Classification UB04 Revenue Code
- 0331 Chemotherapy - Injected UB04 Revenue Code
- 0332 Chemotherapy - Oral UB04 Revenue Code
- 0333 CHEMOTHER/ORAL UB04 Revenue Code
- 0335 Chemotherapy - IV UB04 Revenue Code
- 0339 Other UB04 Revenue Code
- 033X Radiology ? Therapeutic and/or Chemotherapy Administration UB04 Revenue Code
- 0340 General Classification UB04 Revenue Code
- 0341 Diagnostic Procedures UB04 Revenue Code
- 0342 Therapeutic Procedures UB04 Revenue Code
- 0343 NUC MED/RX UB04 Revenue Code
- 0344 Therapeutic Radiopharmaceuticals UB04 Revenue Code
- 0349 Other UB04 Revenue Code
- 034X Nuclear Medicine UB04 Revenue Code
- 0350 General Classification UB04 Revenue Code
- 0351 CT SCAN UB04 Revenue Code
- 0352 Body Scan UB04 Revenue Code
- 0359 Other CT Scans UB04 Revenue Code
- 035X Computed Tomographic (CT) Scan UB04 Revenue Code
- 0360 General Classification UB04 Revenue Code
- 0361 Minor Surgery UB04 Revenue Code
- 0362 Organ Transplant - Other than Kidney UB04 Revenue Code
- 0367 Kidney Transplant UB04 Revenue Code
- 0369 Other Operating Room Services UB04 Revenue Code
- 036X Operating Room Services UB04 Revenue Code
- 0370 General Classification UB04 Revenue Code
- 0371 Anesthesia Incident to RAD UB04 Revenue Code
- 0372 Anesthesia Incident to Other Diagnostic Services UB04 Revenue Code
- 0374 Acupuncture UB04 Revenue Code
- 0379 Other Anesthesia UB04 Revenue Code
- 037X Anesthesia UB04 Revenue Code
- 0380 General Classification UB04 Revenue Code
- 0381 Packed Red Cells UB04 Revenue Code
- 0382 Whole Blood UB04 Revenue Code
- 0383 Plasma UB04 Revenue Code
- 0384 Platelets UB04 Revenue Code
- 0385 Leucocytes UB04 Revenue Code
- 0386 Other Components UB04 Revenue Code
- 0387 Other Derivatives Cryopricipitates) UB04 Revenue Code
- 0389 Other Blood UB04 Revenue Code
- 038X Blood and Blood Components UB04 Revenue Code
- 0390 General Classification UB04 Revenue Code
- 0391 Blood Administration (e.g., Transfusions UB04 Revenue Code
- 0392 Processing and Storage UB04 Revenue Code
- 0399 Blood Processing /Storage; Other Processing and Storage UB04 Revenue Code
- 039X Administration, Processing, and Storage of Blood and Blood Components 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
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