medical billing answers

Revenue Codes

Revenue codes are 3-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill.

Revenue codes go along with procedure codes. When putting them in a charge master, you would add the correct revenue code to the CPT code you were going to use for a particular department. It's the use of revenue codes which allows hospitals to use the same CPT code in multiple departments because it will show which department the services were provided in.

An easy example to use here would be to match up CPT code 99282, which is for an emergency room visit of low to moderate severity, and revenue code 450, which stands for emergency room. In this case, revenue code 450 is the only code that could be used for this CPT code, thus making this one easy to code.

A more complex example to use would be something like CPT 12001, which is a simple laceration repair of a wound on the scalp, trunk of the body, or the extremities such as hands and feet. This procedure could be done in multiple places. It could be done in the OR as part of another procedure; that would be revenue code 360. It could be done in the emergency room; revenue code 450. It could be done in a treatment room; that would be revenue code 761. It could be done in a clinic; that would be revenue code 510. There are at least 3 other revenue codes where this procedure could be performed.

Within most revenue code categories there are subcategories that better define what's going on or what was being used. For instance, revenue code 270 is the general code for supplies. But within that category are nine subcategories:

  • 271 - Nonsterile Supply

  • 272 - Sterile Supply

  • 273 - Take-Home Supply

  • 274 - Prosthetic/Orthotic Devices

  • 275 - Pacemaker

  • 276 - Intraocular Lens

  • 277 - Oxygen Take-Home

  • 278 - Other Implants

  • 279 - Other Supplies/Devices

Every revenue code category has a subcategory that ends in "9" to denote items that don't fit a specific revenue code.

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