UB04/CMS1450 Revenue Codes - Group 08
- 0800 General Classification UB04 Revenue Code
- 0801 Inpatient Hemodialysis UB04 Revenue Code
- 0802 Inpatient Peritoneal (Non-CAPD) UB04 Revenue Code
- 0803 Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD) UB04 Revenue Code
- 0804 Inpatient Continuous Cycling Peritoneal Dialysis (CCPD) UB04 Revenue Code
- 0809 Other Inpatient Dialysis UB04 Revenue Code
- 080X Inpatient Renal Dialysis UB04 Revenue Code
- 0810 General Classification UB04 Revenue Code
- 0811 Living Donor UB04 Revenue Code
- 0812 Cadaver Donor UB04 Revenue Code
- 0813 Unknown Donor UB04 Revenue Code
- 0814 Unsuccessful Organ Search Donor Bank Charge* UB04 Revenue Code
- 0815 STEM CELL ACQUISITION - ALLOGENEIC (EFFECTIVE 1/1/17) UB04 Revenue Code
- 0819 Other Organ Donor UB04 Revenue Code
- 081X Organ Acquisition UB04 Revenue Code
- 0820 General Classification UB04 Revenue Code
- 0821 Hemodialysis/Composite or Other Rate UB04 Revenue Code
- 0822 Home Supplies UB04 Revenue Code
- 0823 Home Equipment UB04 Revenue Code
- 0824 Maintenance/100% UB04 Revenue Code
- 0825 Support Services UB04 Revenue Code
- 0829 Other Hemodialysis Outpatient UB04 Revenue Code
- 082X Hemodialysis - Outpatient or Home Dialysis UB04 Revenue Code
- 0830 General Classification UB04 Revenue Code
- 0831 Peritoneal/Composite or Other Rate UB04 Revenue Code
- 0832 Home Supplies UB04 Revenue Code
- 0833 Home Equipment UB04 Revenue Code
- 0834 Maintenance/100% UB04 Revenue Code
- 0835 PERTNL/HOME/100% UB04 Revenue Code
- 0839 Other Peritoneal Dialysis UB04 Revenue Code
- 083X Peritoneal Dialysis - Outpatient or Home UB04 Revenue Code
- 0840 General Classification UB04 Revenue Code
- 0841 CAPD/Composite or Other Rate UB04 Revenue Code
- 0842 Home Supplies UB04 Revenue Code
- 0843 Home Equipment UB04 Revenue Code
- 0844 Maintenance/100% UB04 Revenue Code
- 0845 Support Services UB04 Revenue Code
- 0849 Other CAPD Dialysis UB04 Revenue Code
- 084X Continuous Ambulatory Peritoneal Dialysis (CAPD) ? Outpatient or Home UB04 Revenue Code
- 0850 General Classification UB04 Revenue Code
- 0851 CCPD/Composite or Other Rate UB04 Revenue Code
- 0852 Home Supplies UB04 Revenue Code
- 0853 Home Equipment UB04 Revenue Code
- 0854 Maintenance/100% UB04 Revenue Code
- 0855 Support Services UB04 Revenue Code
- 0859 Other CCPD Dialysis UB04 Revenue Code
- 085X Continuous Cycling Peritoneal Dialysis (CCPD) ? Outpatient UB04 Revenue Code
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- 086X Reserved for Dialysis (National Assignment) UB04 Revenue Code
- 0870 CELL/GENE THERAPY - GENERAL CLASSIFICATION UB04 Revenue Code
- 0871 CELL/GENE THERAPY - CELL COLLECTION UB04 Revenue Code
- 0872 CELL/GENE THERAPY - SPECIALIZED BIOLOGIC PROCESSING AND STORAGE - PRIOR TO TRANSPORT UB04 Revenue Code
- 0873 CELL/GENE THERAPY - STORAGE AND PROCESSING AFTER RECEIPT OF CELLS FROM MANUFACTURER UB04 Revenue Code
- 0874 CELL/GENE THERAPY - INFUSION OF MODIFIED CELLS UB04 Revenue Code
- 0875 CELL/GENE THERAPY - INJECTION OF MODIFIED CELLS UB04 Revenue Code
- 087X Reserved for Dialysis (National Assignment) UB04 Revenue Code
- 0880 General Classification UB04 Revenue Code
- 0881 Ultra-filtration UB04 Revenue Code
- 0882 Home Dialysis Aid Visit UB04 Revenue Code
- 0889 Other Miscellaneous Dialysis UB04 Revenue Code
- 088X Miscellaneous Dialysis UB04 Revenue Code
- 0890 RESERVED (USE 0250 FOR GENERAL CLASSIFICATION) UB04 Revenue Code
- 0891 PHARMACY - EXTENSION OF 025X AND 063X - SPECIAL PROCESSED DRUGS - FDA APPROVED CELL THERAPY UB04 Revenue Code
- 0892 PHARMACY - EXTENSION OF 025X AND 063X - SPECIAL PROCESSED DRUGS - FDA APPROVED GENE THERAPY UB04 Revenue Code
- 089X Reserved for National Assignment 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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