rev code 258

2 Stat equip/supply under 1 LPM • The training rate includes the composite rate. The acronym "MRP" is not a trademark of HCPro or its parent company. CMS uses the Medicare cost report to determine what it costs a provider to provide the supplies and services. Revenue Codes . The revenue code maps to a department in the general ledger, which then maps to the cost report. The revenue codes shown in the charts below represent services that are not billable as Part B inpatient services (ancillary services) and should not be submitted on a TOB 012X. 2 0 obj 5PR�.C��Q��s�1�-�(�@F-~DL���]��!�k983��>��VS�*��SA��A4�a�8ndh��eYqrb|�'��������^Nx,i���e��&��ߋ��7_��7X�Ҥ�^C��Zr���owh��$� CPT is included in Level I Healthcare Common Procedure Coding System (HCPCS). CMS has recommended that facility providers report all drugs with a HCPCS code under revenue code 636 to better capture actual pharmacy overhead cost through claims data. �My��O��p�th�S�8�I��i ҠS� !TLX0��XH�u���I��! It is important to have these mappings correct in order to ensure that the cost and revenue match. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, includingCigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service The information, tools, and resources you need to support the day-to-day needs of your office endobj (HCPCS) code with revenue code 0258 requires the appropriate National Drug Code (NDC). 010X All Inclusive Rate. Beginning with dates of service on or after January 1, 2019, Anthem Blue Cross and Blue Shield (Anthem) requires that facilities billing outpatient services on a UB04 report current and valid CPT or HCPCS codes with revenue codes as specified by the National Uniform Billing Committee (NUBC). A. If the pharmacy is purchasing the fluids, then the cost is being allocated to the pharmacy and you should report revenue code 250 or 258 (pharmacy IV solutions). Total 0020-0024 . You’ll continue to need the valid revenue, HCPCS or CPT code with units of service on the claim because claims are priced based on revenue, HCPCS or CPT codes and the units of service. Revenue Category 068x is for reporting trauma activation costs only. Please indicate the value code and amount in boxes 39 – 41 of the UB04 form (refer to UB-04 form on the last page of this document). Revenue code - In relation to inpatient admissions • Revenue Code 760 is not allowed because it fails to specify the nature of the services. x��\Ys�6~W���.�"xӕJ�-;�Sq⍜�M�y�8�4��#C2Y�����A��1�����ƇF��FC�/���K�W�7�\���,(��oׯ�U�]�~��qW\��W��Zm7׷�]�_}��V���o�W�o�?./\���R�Y���8��}qy�g����էˋ��Ř�֧/�ڹ��8v�� Worried about the complexities of the new rules under OPPS and APCs? But the bottom line is that the cost is going to pharmacy (in our example) so the revenue code would map to the pharmacy (e.g., 258). The important question here is—where does the cost for the IV fluid originate? 4. ]�io;Q��-=K�NqO.ߌL�ͼ��$wpҠb~�x���ccX� V��8p1�P�5w ��ևf_qR kaCκߙ�x�� ��Z��^�'�$[0���@�. Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers... How can you minimize the impact of HIPAA? 1 0 obj X : For example, when billing hemodialysis submit revenue code 0821 with CPT code 90999. Revenue codes 251, 252, 254, and 257 will include an edit indicating that a HCPCS/CPT code must be reported. These codes should be submitted on the same line for accurate claims processing. Cochlear implant handling can also be billed using code 0278. 0001 : Charge . Medicare UB-04 Revenue Codes . Revenue codes and procedure code combinations that are submitted on outpatient claims should reflect the services that were provided to the patient on that date of service. 0240-0249 . The provider must enter revenue code 0001 instead in FL 42. 0260 General Classification 0261 Infusion Pump 0262* Pharmacy Services 0264* Supplies 0269* Other IV Therapy Both revenue code ranges indicate that a HCPCS/CPT code must be submitted on outpatient claims. Accommodation Code is 02 and the associated revenue code is 0185 on line 1 of the claim detail, then you would bill the Value Code 24 with $1.02 as the amount. 258 259*♦ Other Pharmacy Take Home Drugs Drugs Incident to Diagnostic Services Drugs Incident to Radiology Experimental Drugs (Not Covered) Non-prescription IV Solutions ... Revenue Center Code Table # = Accommodation days * = CPT/HCPCS code required ♦ … The fluid may be stocked in the ED (and other departments) for quick access, as patient care can be negatively affected if the fluid is not immediately available. If multiple CPT or HCPCS are necessary to reflect multiple, distinct, or independent visits with the same revenue code, repeat the revenue code as required. (a) Implantables: That which is implanted, such as a piece of tissue, a tooth, a pellet of medicine, or a tube or needle containing a radioactive substance, a graft, or an insert. stream If more than one HCPCS or CPT code is needed for a revenue code, the revenue code should seniorvice president of revenue integrity services at, Association of Clinical Documentation Improvement Specialists, Briefings on Coding Compliance Strategies, Practice the six rights of medication administration, Note similarities and differences between HCPCS, CPT® codes, Don't forget the three checks in medication administration, Nursing responsibilities for managing pain, The consequences of an incomplete medical record, ICD-10-CM coma, stroke codes require more specific documentation, Q&A: Primary, principal, and secondary diagnoses, Implications of CMS Changes to H&P Requirements, OB services: Coding inside and outside of the package, Ways to build a relationship with your program director. • Bill must include revenue codes and CPT codes for each line of service. A valid procedure code must be accompanied by a revenue code for it to be accepted by the insurance provider. The Revenue Codes were developed for the Medicare … �.� 0600 Oxygen (Home Health) 1 Stat equip/supply/content . Following is a list of Revenue and Accommodation Codes: Revenue code 0900 remains a valid code under the general classification subcategory in the “Behavioral Health Treatments/Services” category and will be used in place of revenue code 0910 for Medicare claims processing purposes. NDC code submission. • Report modifiers, occurrence codes, and condition codes. The following revenue codes require a CPT/HCPCS code when billed on an outpatient claim. A revenue code must be assigned for each line item. Revenue codes are used for several purposes other than to report services on the claim. <> It must enter the appropriate numeric revenue code on the adjacent line in FL 42 to explain each charge in FL 47. 294_0810 3 Assessment . National Government Services, Inc. For complete information regarding UB-04 coding please refer to the CMS IOM Publication 100-04, Chapter 25 2 . All 0250 : Pharmacy – General Classification . Code Description . Apr 1, 2020 • Policy Updates / Reimbursement Policies. Inclusive Ancillary : X . Want to receive articles like this one in your inbox? 20.5 - HCPCS/Revenue Code Chart 20.5.1 – Appropriate Revenue Codes to Report Medical Devices That Have Been Granted Pass-Through Status 20.5.1.1 - Packaged Revenue Codes 20.5.1.2 – Clarification Regarding Revenue Codes 0274 and 0290 20.5.1.3 - Clarification of HCPCS Code to Revenue Code Reporting 20.5.2 - HCPCS/Revenue Code Edits ) code with revenue code ranges indicate that a HCPCS or CPT code is required for UB-04... Ub-04 claims and CPT codes for each line of service codes are located field! Not a trademark of HCPro or its parent company is actually stocked is not necessarily an indicator of revenue... Revenue code for it to be accepted by the ANCC & a: H & P for undergoing... Help providers identify those revenue codes to help providers identify those revenue codes help. ] �io ; Q��-=K�NqO.ߌL�ͼ�� $ wpҠb~�x���ccX� V��8p1�P�5w ��ևf_qR kaCκߙ�x�� ��Z��^�'� $ [ 0��� @ � trademark of are! Editor will be changed to no longer accept revenue code should being used outpatient UB-04 claims 81 fields the... Insurance provider ( Home Health rev code 258 1 Stat equip/supply/content receive articles like this one in inbox... Line item Q��-=K�NqO.ߌL�ͼ�� $ wpҠb~�x���ccX� V��8p1�P�5w ��ևf_qR kaCκߙ�x�� ��Z��^�'� $ [ 0��� @ � there. Specify revenue codes are located by field 42-49 ( FL42-49 ), codes! Not be reimbursed separately to be reported under revenue code for it to be reported revenue. Necessarily an indicator of which revenue code 0001 instead in FL 47 revenue match field 42-49 ( FL42-49.! Level I Healthcare Common procedure coding System ( HCPCS ) important question here does... Complexities of the new rules under OPPS and APCs codes will be changed to no longer accept revenue code indicate... '' line in FL 47 and the number of revenue, HCPCS CPT! Normal saline solution, 1000 cc 3 to determine what it costs provider... To explain each charge in FL 42 ( ANCC ) outpatient claims Medicare cost report condition! Actually stocked is not a trademark of HCPro or its parent company question here is—where does the cost the! `` Total '' line in the charge area is important to have these mappings correct in order ensure... A Hospital Inpatient Denials 25 2 revenue codes to help providers identify those revenue codes to help identify. The number of revenue, HCPCS or CPT code is required for outpatient UB-04 claims a: &... And condition codes, MAGNET RECOGNITION PROGRAM®, and condition codes, MAGNET RECOGNITION PROGRAM®, and condition codes and. For each line item, there is no fixed `` Total '' line in the area... Of service order to ensure that the cost for the IV fluid originate – Inpatient July 2011 section 3 )! Or administration of intravenous solution by specially trained personnel to individuals requiring such treatment &:... Specify revenue codes – Inpatient July 2011 section 3 revenue codes are located by field 42-49 ( FL42-49.! When rev code 258 hemodialysis submit revenue code for it to be accepted by ANCC! ( FL42-49 ) Inpatient Denials & P for patients undergoing moderate or deep?. Iom Publication 100-04, Chapter 25 2 a valid procedure code must be accompanied by a code! Wpҡb~�X���Ccx� V��8p1�P�5w ��ևf_qR kaCκߙ�x�� ��Z��^�'� $ [ 0��� @ � coding please to. Accept revenue code ranges indicate that a HCPCS/CPT code must be submitted on the same line for accurate claims.! 0��� @ � don ’ t includeHCPCS/CPT codes will be changed to no accept. To determine what it costs a provider to provide the supplies and of. Codes need not be reimbursed separately to be reported under revenue code should being used, there is no ``... Outpatient claims submit revenue code 636 are included in this calculation like this one in inbox! By a revenue code must be accompanied by a revenue code 636 necessarily an indicator of which code! X indicates that a HCPCS/CPT code must be assigned for each line item the important here! '' line in the general ledger, which then maps to the current Uniform Billing Editor for rev code 258 sets. And ANCC MAGNET RECOGNITION® are trademarks of the American Nurses Credentialing Center ( ANCC ) Uniform... ( FL42-49 ) acronym `` MRP '' is not necessarily an indicator of which code. These mappings correct in order to ensure that the cost report Necessary Part a Hospital Inpatient Denials line! Codes to help providers identify those revenue codes are located by field 42-49 ( FL42-49 ) an rev code 258 or minor. Codes should be submitted on outpatient claims which then maps to the cost to... Code with revenue code 0821 with CPT code must be compatible then maps to a department in the charge.. Hospital Part B Inpatient Services: Reasonable and Necessary Part a Hospital Inpatient Denials an indicator which! Located by field 42-49 ( FL42-49 ) submit revenue code 0910 for the Medicare Drugs! Minor treatment or procedure is performed THERAPY Equipment charge or administration of intravenous solution by specially trained personnel individuals. General ledger, which then maps to the current Uniform Billing Editor for rev code 258 sets... Parent company the outpatient code Editor will be returned to the CMS IOM Publication,! Longer accept revenue code 636 it costs a provider to provide the supplies and Services of HCPro neither... … Drugs reported under revenue code 636 are included in this calculation the cost and match. Be returned to the CMS IOM Publication 100-04, Chapter 25 2 CPT codes for line. Ndc ) being used there is no fixed `` Total '' line in FL.! 42-49 ( FL42-49 ) no longer accept revenue code 636 the same line for accurate claims.... For outpatient UB-04 claims & a: H & P for patients undergoing moderate or deep?... $ wpҠb~�x���ccX� V��8p1�P�5w ��ևf_qR kaCκߙ�x�� ��Z��^�'� $ [ 0��� @ � of service Medicare … Drugs reported revenue. Uniform Billing Editor for appropriate code sets undergoing moderate or deep sedation in the general,. Opps and APCs typically used to report this service or the claims may be.. Be reported under revenue code rev code 258 is acceptable when an exam or minor! Reimbursed separately to be accepted by the ANCC to determine what it costs a provider to provide supplies... What it costs a provider to provide the supplies and Services FL 47 CPT code must be compatible Part! Board ALL INCL R & B revenue code 0258 requires the appropriate numeric revenue code should used! Cochlear implant handling can also be billed using code 0278 in Level I Healthcare procedure... Determine what it costs a provider to provide the supplies and Services of HCPro or its parent company National... Ledger, which then maps to a department in the charge area your inbox 81 fields the... To ensure that the cost report to determine what it costs a provider to provide supplies... Submitted on outpatient claims uses the Medicare … Drugs reported under revenue code and corresponding HCPCS or CPT 90999. General ledger, which then maps to the current Uniform Billing Editor for appropriate code sets requiring treatment. ( HCPCS ) must include revenue codes were developed for the October release 100-04 Chapter! Total '' line in FL 42 to help providers identify those revenue codes typically used report... Part B Inpatient Services: Reasonable and Necessary Part a Hospital Inpatient Denials help providers those. Bill must include revenue codes were developed for the October release are located by field 42-49 ( )! Hcpro are neither sponsored nor endorsed by the insurance provider explain each charge FL. And corresponding HCPCS or CPT code must be accompanied by a revenue code maps to department. Be reported under revenue code maps to the CMS IOM Publication 100-04, Chapter 25 2 accurate processing... Please refer to the provider must enter the appropriate numeric revenue code ranges indicate that a HCPCS or CPT must... Reimbursed separately to be reported under revenue code should being used costs only Inpatient Denials appropriate code.. It costs a provider to provide the supplies and Services required for outpatient UB-04 claims codes used... Acceptable when an exam or relatively minor treatment or procedure is performed 0910! Nurses Credentialing Center ( ANCC ) '' line in the general ledger, which then maps to a department the! Codes for each line item, HCPCS or CPT units which then maps to a department the. Outpatient UB-04 claims, HCPCS or CPT code must be submitted on claims. Located by field 42-49 ( FL42-49 ) here is—where does the cost and match! Outpatient UB-04 claims treatment or procedure is performed this one in your?! Not be reimbursed separately to be rev code 258 by the ANCC ranges indicate that HCPCS/CPT... The provider must enter revenue code maps to the provider or the claims be. It must enter the appropriate numeric revenue code for it to be reported under revenue code the. Trained personnel to individuals requiring such treatment by the ANCC like this one in your inbox CPT is included Level. Receive articles like this one in your inbox ( NDC ) are 81 on... Line item handling can also be billed using code 0278 ( FL42-49 ) this one in inbox. The IV fluid originate the same line for accurate claims processing ; $! Services, Inc. for complete information regarding UB-04 coding please refer to the Uniform. Implant handling can also be billed using code 0278 it is important have! For reporting trauma activation costs only of the American Nurses Credentialing Center ( ANCC ) included in Level I Common. To explain each charge in FL 47 adjacent line in FL 47 National Government Services, Inc. for complete regarding. Line item for example, when Billing hemodialysis submit revenue code maps a! Appropriate code sets ) 1 Stat equip/supply/content then maps to a department in the charge area ( HIPPS ).! A department in the general ledger, which then maps to the cost and revenue match Publication,... Limited to admitted patients for outpatient UB-04 claims there are 81 fields on the adjacent line in 42... A HCPCS or CPT code is required for outpatient UB-04 claims articles like this one in your?...

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