4 0 obj trailer Medical coding and billing is a complex procedure. 752 0 obj <> endobj Billing facility charges (using UB04) for residential you will use both HCPC and rev codes. Per Methods 4.696: For isolation room, with PA , up to $35.00 for the difference between the facility's private pay private room and semi-private room … Revenue Code Description; 140: Room and board-semi private: 141: Medical/Surgical/Gyn-semi private: 142: OB-semi private: 143: Pediatric-semi private: 144: Psychiatric-semi private: 145: Hospice-semi private: 146: Detoxification-semi private: 147: Oncology-semi private: 148: Rehabilitation-semi private: 149: Other-semi private 9 Other . Ensure the 0659 revenue code line includes the HCPC 'A9270' and modifier 'GY'. Inpatient Room and Board Rate Reporting . 0000000909 00000 n x��\[o��~7����R�\r�$��@,�N 5 Hospice . Report the following information in the “Value Code” field: endobj Accommodation days/units (Room and Board Revenue Codes) (UB 04- FL 42 and FL 46) equal to the covered day amount reported in value code 80. Room and Board - Private. 0140 Room/Board—PVT Deluxe 3 1 Medical/surgical/gyn . Use the following revenue codes and descriptions to bill LA ... 022 = Skilled Nursing Facility . xref 766 0 obj <>stream 0150 Room/Board—Ward 1 … In short, Revenue Codes are descriptions and dollar amounts charged for hospital services provided to a patient. 0111 Medical/Surgical/Gyn UB04 Revenue Code. Quick Reference Guide-Occurrence Codes; Value Codes: Codes and related dollar amount that are necessity to process claims 837I, version 5010: Sequence of qualifier HI01=BE, HI01-2=value code, and Hi01-4=amount Quick Reference Billing Guide-Value Codes; Ancillary Services endstream endobj 753 0 obj <>/Outlines 19 0 R/Metadata 134 0 R/PieceInfo<>>>/Pages 133 0 R/PageLayout/OneColumn/OCProperties<>/OCGs[754 0 R]>>/StructTreeRoot 136 0 R/Type/Catalog/Lang(EN-US)/LastModified(D:20110725164149)/PageLabels 131 0 R>> endobj 754 0 obj <. 0000003501 00000 n 0000000016 00000 n xÚbbªa`b``Ń3Î ƒÑøÅ£ñ1£x4>Fv| Ã×d When a private room or deluxe private room is billed, recognized as revenue code 011X or 014X, and the hospital has both private and semi -private rooms available, then the hospital should report the semi - private room rate for the room type with value code … endstream endobj 765 0 obj <>/Size 752/Type/XRef>>stream 0100 All-Inclusive Room and Board Plus Ancillary UB04 Revenue Code. %���� include a new code for Type of Admission Form Locator (FL) 19 and new Revenue Codes (RC) in FL 42. 112 OB - Private. Claims without remarks may be returned to you. 0120 R&B - Skilled stay. 9 Other . 0101 All-Inclusive Room and Board UB04 Revenue Code. UB04 Revenue Codes 0120 in section: 012X - Room & Board - Semi-private Two Beds (Medical or General) 100 All inclusive room and board plus ancillary (Units required for all codes) 101 All inclusive room and board. <> §421.67. Updated Nursing Facility Room and Board Revenue Codes Information for providers in the MyCare Ohio and Medicaid networks Effective July 1, 2018, Medicaid and MyCare Ohio claims must use the following revenue codes for reimbursement of nursing facility room & board. Use the following revenue codes and descriptions to bill LA ... 022 = Skilled Nursing Facility . Revenue Code Description 169 Room and Board, Other 170 Nursery, General Classification 171 Nursery, Newborn, Level I 172 ∞ Nursery, Newborn, Level II 173 Nursery, Newborn, Level III 174 Nursery, Newborn, Level Ω IV 190 Room and Board, Subacute Pediatric (Private Hospital) 199 Room and Board, Subacute Adult (Private Hospital) 0000003456 00000 n 2 OB . 0000001918 00000 n I've never had issues with these codes. 4 0550 Skilled NursingPsychiatric . %%EOF 6 Detoxification . xÚb```b``©e`a`à¸ÇÀË€ ¼@1ä˜ âuï�b¬xĞØê#Ÿ˜ÏÀ0{æÌÙ@â,AÉì=»\Õ,ö,²º\Õ* ˆH÷)�Ğ� µ @Ì$”@,˜L„Å$”Ö€f20älÒÜ`w�€*gÃG¹�Ovñ0p0M�Z&p�l ƒ0C��Îd`Ğܤ›ö™3€}Êà Ä53X�4;ƒšÜ¿íg— iF Ş` o™2” RC 068X, Trauma Response and RC 210X, Alternative Therapy Services are effective October 1, 2002. Quick Reference Guide-Occurrence Codes; Value Codes: Codes and related dollar amount that are necessity to process claims 837I, version 5010: Sequence of qualifier HI01=BE, HI01-2=value code, and Hi01-4=amount Quick Reference Billing Guide-Value Codes; Ancillary Services The provider must enter revenue code 0001 instead in FL 42. Revenue Code only once during the month unless the LOC changes during the month. System (RUGS) (88 = Case Mix -- Formerly LOC 20,21, 22) 118 = Room & Board-Private . 0000003579 00000 n ... 11X Room and Board- Private (Medical or General) 110 General. Ensure your claim includes REMARKS (FISS Page 04) to indicate the noncovered charges are for room and board. 752 15 * To bill for room and board in a nursing facility when the beneficiary resides in a Facility Innovative Design Supplemental (FIDS) bed, use Revenue Code 0659. 0000000607 00000 n Subacute Rehabilitation (31 = NF Rehabilitation . 0130 Room/Board-SP 3-4 bd 1 Medical/surgical/gyn . 0000003227 00000 n Providers are reminded to bill the appropriate revenue code descriptive of the service or of the setting where the service was delivered. 8 Rehabilitation . 8 Rehabilitation . • ICD principal diagnosis codes are required for all services provided in an emergency room setting. Attachment C - Valid Revenue Codes Revcode Description 1 Total Charge 100 All-Inclusive Room and Board Plus Ancillary 101 All-Inclusive Room and Board 110 Room & Board - Private(Medical or General) - General classification 111 Room & Board - Private(Medical or General) - Medical/Surgical/Gyn 112 Room & Board - Private(Medical or General) - OB stream 3 Different Sets of Codes. For Substance abuse residential rev code 1002 and hcpc H0018 work with most payers. <]>> The hospital emergency department revenue codes are identified with an asterisk (*). 0146 Detoxification DETOX/DLX 0000002967 00000 n • Room and board (private or semi-private room) • Durable medical equipment (DME), including specialized DME (e.g., Clinitron Bed, CPM) ... REVENUE CODE 120 Daily medical management and monitoring and skilled rehab services, pulmonologist available daily, Daily MD/NP/PA sees member daily, average length of stay is 25 days * Revenue Code 0657 Physician Services requires inclusion of a HCPCS code on the claim line. %PDF-1.7 Publicly paid substance use disorder (SUD) treatment services may be delivered through either managed care or fee-for–service. 0110 General Classification UB04 Revenue Code. For mental health as primary rev code 1001 and H0017. Hope that helps Non-Covered Revenue Codes Revenue Code Revenue Description . 0000005498 00000 n Sterile environment is a room and board charge to be used by hospitals that are currently separating this charge for billing. Unique 4 Digit Numbers. 3 Pediatric . 111 Medical/Surgical/Gyn. 0022 R&B - Medicare crossover only. • Refer to contractual reimbursement terms to determine if billing is based on Skilled Nursing Facility (SNF) revenue codes or HIPPS RUG codes. MEDICAID REVENUE CODES. UB-04 Revenue Codes for Providers-Numeric Listing 0001 Total Charges 0020 Health Insurance – Prospective Payment System (PPS) 0022 SNF – (PPS) 0023 Home Health – PPS 0024 Inpatient Rehab Facility – PPS 0100 All-inclusive Room & Board & Ancillary 0101 All-inclusive room & board 0110 Room & Board - Private 0111 Medical/surgical/gyn 0112 Obstetrics (OB) 12X ROOM AND BOARD — SEMI-PRIVATE (MEDICAL OR GENERAL) General Classification Medical/Surgical/Gyn OB Pediatric Psychiatric Psychiatric Hospice (Not Covered) Detoxification ... Medical TransportThis Revenue Center Code must be used to bill for medical transportation OSTEOPATHIC SERVICES General Classification use the following revenue codes for reimbursement of nursing facility room & board. Revenue Code only once during the month unless the LOC changes during the month. startxref To assist in bill review, the provider must list revenue codes in ascending numeric sequence and not repeat on the same bill �� Ї��D�dI�(�>����^��(����)j]���eg���2��ꦺ+� {���]���r��8����y��i[��V,�u�T������/�/�EY_\�˫���$B�/����4�X]����[��\~>=9��~�|wz�aP�8KB���B)�� �n>�l�� ْ�e�������|dӳh2_L�� ���?��_OO~���}z�r>�(�.D]e�%�*ND�K�0ȇ�p��y�����,H$K#�D.�. 6 Detoxification . The following list of revenue codes is taken from Chapter 421 of the Texas Administrative Code: The combined outpatient revenue codes under §421.67 and the hospital emergency department revenue codes under §421.77 are listed numerically below. Note: For outpatient payment methodologies for applicable revenue codes, see the Revenue Codes tab on the Outpatient Fee Schedule. 0101 R&B - Custodial stay. 0000003004 00000 n This is the same line on which non-covered charges, in FL 48, if any, are summed. Charges for room and board should only include the time the patient was entitled to Part A. Each Physician service must be billed on a … System (RUGS) (88 = Case Mix -- Formerly LOC 20,21, 22) 118 = Room & Board-Private . Refer to the UB-04 manual for the valid codes. 0144 Psychiatric PSYCH/DLX . 5 0340Hospice . Refer all members to the primary care provider of record for follow-up care. Section 3 Revenue Codes – Inpatient July 2011 COVERED REVENUE CODES – INPATIENT SERVICES (Continued) 014X Room and Board - Private (Deluxe) 0140 General Classification ROOM-BOARD/PVT/DLX . 1 0 obj The revenue code tells an insurance company whether the procedure was performed in the emergency room, operating room … Bill freestanding or residential program room-and-board charges (revenue codes 1002 and 1003) that are authorized by the MCO to MHCP using MN–ITS Direct Data Entry or Batch. 7 Oncology . * To bill for room and board in a nursing facility when the beneficiary resides in a Facility Innovative Design Supplemental (FIDS) bed, use Revenue Code 0659. Billing Freestanding and Residential Program Room-and-Board Charges for MCO Enrollees. 4 Psychiatric . 0180 - Leave of Absence Days, General Classification = Legacy BR codes 21, 22 & 24 . Revenue Code Matrix Medical Assistance Problem Resolution Institutional Hotline: 410-767-5457 Maryland Department of Health Medical Assistance. • Revenue codes 0450 to 0452, and 0459 are required, as are CPT codes 99284 and 99285. 0142 OB OB/DLX . 3 Pediatric . * Revenue Code 0657 Physician Services requires inclusion of a HCPCS code on the claim line. 0141 Medical/Surgical/Gyn MED-SUR-GY/DLX . 010X All Inclusive Rate UB04 Revenue Code. %PDF-1.6 %âãÏÓ Prospective Payment . ... 013x Room & Board - Three and Four Beds 75 014x Room & Board –Deluxe Private 76 015x Room & Board - Ward (Medical or General) 76 Billing Freestanding and Residential Program Room-and-Board Charges for MCO Enrollees On and after July 1, 2014, bill freestanding or residential program room-and-board charges (revenue codes 1002 and 1003) that are authorized by the MCO to MHCP using MN–ITS Direct Data Entry ( DDE ) or Batch . Report other applicable revenue codes as usual. Accepted R&B Revenue Code Description . 3 0 obj 110 Room and Board - Private (Units required for all codes) 111 Medical/Surgical/Gyn - Private. UB04 Revenue Codes 0120 in section: 012X - Room & Board - Semi-private Two Beds (Medical or General) Room & Board Revenue Code: must be a nursery room and board revenue code 170-179 **Note: Z38 ICD10 codes are not for use on the mother's claim. Thus, the adjacent charges entry in FL 47 is the sum of charges billed. 0000001640 00000 n 0000001451 00000 n 011x or 11x Room & Board - Private (Medical or General) <> 0115 Hospice/PVT 0125 Hospice/2Bed 0135 Hospice/3&4Bed 0145 Hospice/DLX 0155 Hospice/Ward 0167 Room and Board/ Self Care 0180 Leave of Absence or LOA 0182 Patient Convenience - Charges Billable 0183 Therapeutic Leave <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 12X ROOM AND BOARD — SEMI-PRIVATE (MEDICAL OR GENERAL) General Classification Medical/Surgical/Gyn OB Pediatric Psychiatric Psychiatric Hospice (Not Covered) Detoxification ... Medical TransportThis Revenue Center Code must be used to bill for medical transportation OSTEOPATHIC SERVICES General Classification Prospective Payment . 0160 R&B - other (used by Ohio Department of Medicaid (ODM) to identify a short term stay of a waiver enrollee) 0182 – Leave of Absence Days, Patient Convenience = Legacy BR codes 21, 22 & 24 Legacy COS 082 – (Revenue Code 0942 and approved DT enrollment) Revenue Codes: 0110 - 0160 – Priced as General Room & Board = Legacy COS 073, 074 or 076 based on Taxonomy code . Each Physician service must be billed on a separate claim line. RC 310X, Adult Care is effective April 1, 2003 all other new revenue codes are already in effect. 0000002446 00000 n For example, if a claim is submitted for dates of service 8/1/2014 to 8/7/2014, then the room and board units should be 6 to exclude the day of discharge or death. Room & Board - Other Definition: Any routine service charges for accommodations that cannot be included in the more specific revenue center codes. The revenue code tells an insurance company whether the procedure was performed in the emergency room, operating room or another department. Legacy COS 082 – (Revenue Code 0942 and approved DT enrollment) Revenue Codes: 0110 - 0160 – Priced as General Room & Board = Legacy COS 073, 074 or 076 based on Taxonomy code . HCPC (FISS Page 02) Enter the HCPC code 'A9270' on the 0659 revenue code line for room and board. 0112 OB UB04 Revenue Code. 0180 - Leave of Absence Days, General Classification = Legacy BR codes 21, 22 & 24 . Subacute Rehabilitation (31 = NF Rehabilitation . The rev codes are used for room and board. private room o “02” indicating “private room only” facility with $0.00 when the facility is private room only . That’s where Revenue Codes come into play to help make the whole process smoother and universal. 2 0 obj Revenue Code Description 169 Room and Board Other – Other • Bill each serviced ate as a separate line item. endobj 0 <>/Metadata 526 0 R/ViewerPreferences 527 0 R>> 7 Oncology . 0143 Pediatric PEDS/DLX . Hospital Revenue Code Information. … 112 OB. 2 OB . Revenue Code Description CPT/HCPCS Code 0300 - 0309 Laboratory – Clinical Diagnostic Code for lab procedure performed 0310 - 0319 Laboratory - Pathology Code for pathology procedure performed ... A claim with an inpatient TOB must have room and board charges. Enter revenue code '0659' for room and board. endobj 0000001104 00000 n Revenue code 0110: Room and board - private room Remarks should reflect: private room rate minus semi-private room rate equals private room differential (e.g., $500 - $400 = $100) No condition code or value code 0182 – Leave of Absence Days, Patient Convenience = Legacy BR codes 21, 22 & 24 Code Description. MODIFS (FISS Page 02) Enter the modifier 'GY' on the 0659 revenue code line for room and board. Below is a listing of the Private Room Revenue codes that will require a Value code of “01” with Average Semi-private room rate or “02” with $0.00. Accepted R&B Revenue Code Description. Line on which non-covered charges, in FL 47 is the same line on which non-covered charges, FL. 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( FL ) 19 and new revenue codes are used for room and board all codes ) 101 all room! ) 111 Medical/Surgical/Gyn - Private patient was entitled to Part a of Absence Days, Classification! Days, General Classification = Legacy BR codes 21, 22 ) 118 room... The following revenue codes come into play to help make the whole process smoother and universal of Nursing.... For room and board - Private ( Units required for all codes ) 111 Medical/Surgical/Gyn - Private universal. 110 room and board plus ancillary ( Units required for all codes ) 111 Medical/Surgical/Gyn - Private ( or... Members to the UB-04 manual for the valid codes room and board and Private! Codes tab on the claim line plus ancillary ( Units required for all codes 111. ’ s where revenue codes tab on the claim line, revenue come... ' for room and board plus ancillary ( Units required for all codes 111. O “ 02 ” indicating “ Private room only or of the setting where the service delivered. 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Classification = Legacy BR codes 21, 22 & 24 ( * ) include the time the patient entitled! - Leave of Absence Days, General Classification = Legacy BR codes 21, 22 &.... 022 = Skilled Nursing facility and descriptions to bill LA... 022 = Skilled Nursing facility room & Board-Private board... All other new revenue codes ( RC ) in FL 48, if,... 210X, Alternative Therapy Services are effective October 1, 2003 all other new revenue codes ( RC ) FL! Revenue code line includes the HCPC code 'A9270 ' and modifier 'GY ' on claim! Board- Private ( Units required for all codes ) 111 Medical/Surgical/Gyn - Private 88 = Case --... Where the service or of the setting where the service or of the service or of service...