Rev code 180

Rev code 180 DEFAULT

Unique 4 Digit Numbers

Medical coding and billing is a complex procedure.  That’s where Revenue Codes come into play to help make the whole process smoother and universal.

In short, Revenue Codes are descriptions and dollar amounts charged for hospital services provided to a patient.  The revenue code tells an insurance company whether the procedure was performed in the emergency room, operating room or another department.

3 Different Sets of Codes

Hospitals run on three sets of universal codes:

  1. ICD-9 – for diagnoses
  2. CPT – for procedures
  3. HCPCS – for medical goods and services.

These codes are located in various places on the UB-04 forms (bill form used by Hospitals and other providers), the purpose of Revenue Codes, however, is to group similar types of charges onto one line in the form.

If a revenue code is attached to a supply code, it identifies the equipment and whether the equipment was used in the hospital or taken home by a patient. This is important because many of the procedures done in the hospital may be done in different areas.  For example, stitches may be given to a patient in the emergency room, or in a completely different area of the hospital like the maternity ward.  Depending on where the procedure was done the price for the procedure can be drastically different.  We therefore see the tremendous role that Revenue Codes have in the revenue cycle of a hospital.

A valid procedure code must be accompanied by a revenue code for it to be accepted by the insurance provider.  There are 81 fields on the UB-04 and the Revenue Codes are located by field 42-49 (FL42-49).  The Revenue Codes were developed for the Medicare system but were soon adopted as standard for hospitals.  Every item in a hospital’s chargemaster (catalog of all services performed by that hospital) must have one revenue code attached to it.

From 3 to 4 Digits

Originally Revenue Codes were 3 digits, however, the need for additional codes required the addition of a new digit.  Nowadays, the code is always 4 digits, the first digit is typically a zero and many insurance agencies will assume a zero for the first digit rather than require it to be listed.  When the last digit of a Revenue Code is a zero this indicates that the service was unspecified and a more specific assignment could not be made.  When the last digit is a nine this indicates that “other” services within the specified category were performed which do not have a specific code assigned to them.  A claim form sent to an insurance provider without a Revenue Code will be rejected, and only Revenue Codes that are covered by the insurance provider will be paid.

The list of Revenue Codes is quite extensive.  To demonstrate just how many codes there are, check out this list:

11X         Room and Board- Private (Medical or General)

110         General

111         Medical/Surgical/Gyn

112         OB

113         Pediatric

114         Psychiatric

115         Hospice

116         Detoxification

117         Oncology

118         Rehabilitation

119         Other

12x         Room and Board-Semi-Private Two Bed (Medical or General)

120         General

121         Medical/Surgical/Gyn

122         OB

123         Pediatric

124         Psychiatric

125         Hospice

126         Detoxification

127         Oncology

128         Rehabilitation

129         Other

13x         Semi-Private- Three and Four Beds

130         General

131         Medical/Surgical/Gyn

132         OB

133         Pediatric

134         Psychiatric

135          Hospice

136          Detoxification

137          Oncology

138          Rehabilitation

139          Other

14x          Private (Delux)

140         General

141         Medical/Surgical/Gyn

142         OB

143         Pediatric

144         Psychiatric

145         Hospice

146         Detoxification

147         Oncology

148         Rehabilitation

149         Other

15x      Room and Board Ward (Medical or General)

150         General

151         Medical/Surgical/Gyn

152         OB

153         Pediatric

154         Psychiatric

155         Hospice

156         Detoxification

157         Oncology

158         Rehabilitation

159         Other

16x         Other Room and Board

160         General

164         Sterile Environment

167         Self Care

168         Rehabilitation

169         Other

17x          Nursery

170         Newborn (well baby)

171         Newborn-level I                                                    Routine

172         Newborn-level II                                                   Low-birth weight

173         Newborn-level III                                                  Sick baby

174         Newborn-level IV                                                  Severly ill baby/ICU

179         Boarder baby

18x          Leave of Absence

180         General

181         Reserved

182         Patient Convenience Charges Billable                Billable

183         Therapeutic Leave                                                      Billable

184         ICF/MR-any reason                                                   Billable

185         Nursing Home (for hospitalization)                     Billable

189         Other Leave of Absence

19x        Subacute care

190         General Classification

191          Subacute Care-level I                                               Skilled Care

192          Subacute Care-level II                                            Comprehensive Care

193          Subacute Care-level III                                          Complex Care

194          Subacute Care-level IV                                           Intenstive Care

199          Other Subacute Care

20x          Intensive Care

200         General

201         Surgical

202         Medical

203         Pediatric

204         Psychiatric

206         Intermediate ICU

207         Burn Care

208         Trauma

209         Other Intensive Care

21x          Coronary Care

210         General

211         Myocardial Infarction

212         Pulmonary Care

213         Heart Transplant

214         Intermediate CCU

219         Other Coronary Care

22x               Special Charges

220         General

221         Admission Charge

222         Technical Support Charge

223         U.R. Service Charge

224         Medically Necessary Late Discharge

229         Other Special Charges

23x          Incremental Nursing Care Rate

230         General

231         Nursery

232         OB

233         ICU

234         CCU

235         Hospice

239         Other

24x               All Inclusive Ancillary

240         General

249         Other Inclusive Ancillary

25x          Pharmacy

250         General

251         Generic Drugs

252         Non-generic Drugs

253         Take Home Drugs

254         Drugs incidental to other Diagnostic Services

255         Drugs incidental to Radiology

256         Experimental Drugs

257         Non-prescription

258         IV Solutions

259         Other Pharmacy

26x          IV Therapy

260         General

261         Infusion Pump

262         IV Therapy/Pharmacy Services

263         IV Therapy/Drug/Supply Delivery

264         IV Therapy/Supplies

269         Other IV Therapy

27x               Medical/Surgical Supplies and Devices

270         General

271         Non-Sterile Supply

272         Sterile Supply

273         Take Home Supplies

274         Prosthetic/Orthotic Devices

275         Pace Maker

276         Intraocular Lens

277         Oxygen-Take Home

278         Other Implants

279         Other Supplies/Devices

28x               Oncology

280         General

289         Other Oncology

29x              Durable Medical Equipment (Other than Renal)

290         General

291         Rental

292         Purchase of New DME

293         Purchase of Used DME

294         Supplies/Drug for DME Effectiveness

299         Other Equipment

30x               Laboratory-Clinical

300         General

301         Chemistry

302         Immunology

303         Renal Patient (home)

304         Non-routine Dialysis

305         Hematology

306         Bacteriology & Microbiology

307         Urology

309         Other Laboratory

31x               Laboratory Anatomical

310         General

311         Cytology

312         Histology

314         Biopsy

319         Other

32x               Radiology-Diagnostic

320         General

321         Angiocardiography

322         Arthrography

323         Arteriography

324         Chest X-ray

329         Digital Subtraction Angiography

33x               Radiology-Therapeutic

330         General

331         Chemotherapy-injected

332         Chemotherapy-oral

333         Radiation Therapy

335         Chemotherapy-IV

339         Other

34x          Nuclear Medicine

340         General

341          Diagnostic

342          Therapeutic

343          Diagnostic Radiopharmaceuticals

344         Therapeutic Radiopharmaceuticals

349          Other

35x          CT Scan

350         General

351          Head Scan

352          Body Scan

359          Other CT Scans

36x          Operating Room Services

360          General

361          Minor Surgery

362         Organ Transplant-Other Than Kidney

367         Kidney Transplant

369         Other Operating Room Services

37x         Anesthesia

370         General

371         Anesthesia incident to Radiology

372         Anesthesia incident to Other Diagnostic Services

374         Acupuncture

379          Other Anesthesia

38x          Blood

380         General

381          Packed Red Cells

382          Whole Blood

383          Blood-Plasma

384          Blood-Platelets

385          Blood-Leucocytes

386          Blood-Other Components

387          Blood-Other Derivatives

389          Other Blood

39x               Blood Storage and Processing

390         General

391         Blood Administration

399         Other Blood Storage & Processing

40x               Other Imaging Services

400         General

401         Diagnostic Mammography

402         Ultrasound

403         Screening Mammography

404         Positron Emission Tomography

409         Other Imaging Services

41x               Respiratory Services

410         General

412         Inhalation Services

413         Hyperbaric Oxygen Therapy

419         Other Respiratory Services

42x               Physical Therapy

420         General

421         Visit Charge

422         Hourly Charge

423         Group Rate

424         Evaluation or Re-evaluation

429         Other Physical Therapy

43x               Occupational Therapy

430         General

431         Visit Charge

432         Hourly Charge

433         Group Rate

434         Evaluation or Re-evaluation

439         Other Occupational Therapy

44x               Speech-Language Pathology

440         General

441         Visit Charge

442         Hourly Charge

443         Group Rate

444         Evaluation or Re-evaluation

449         Other Speech-Language Pathology

45x               Emergency Room

450         General

451         EMTALA Emergency Medical Screening Services

452         ER Beyond EMTALA Screening

456         Urgent Care

459         Other Emergency Room

46x               Pulmonary Function

460         General

469         Other Pulmonary Function

47x               Audiology

470         General

471         Diagnostic

472         Treatment

479         Other Audiology

48x               Cardiology

480         General

481         Cardiac Cath Lab

482         Stress Test

483         Echocardiology

489         Other Cardiology

49x               Ambulatory Surgical Care

490         Ambulatory Surgical Care

499         Other Ambulatory Surgical Care

50x               Outpatient Services

500         General

509         Other Outpatient

51x               Clinic

510         General

511         Chronic Pain Center

512         Dental Clinic

513         Psychiatric

514         OB-GYN

515         Pediatric

516         Urgent Care Clinic

517         Family Practice Clinic

519         Other Clinic

52x               Freestanding Clinic

520         General

521         Rural Health-Clinic

522         Rural Health-Home

523         Family Practice

526         Urgent Care Clinic

529         Other Freestanding Clinic

53x               Osteopathic Services

530         General

531         Osteopathic Therapy

539         Other Osteopathic Services

54x               Ambulance

540         General

541         Supplies

542         Medical Transport

543         Heart Mobile

544         Oxygen

545         Air Ambulance

546         NeoNatal

547         Pharmacy

548         Telephone Transmission EKG

549         Other Ambulance

55x               Skilled Nursing (Home Health & CORFs only)

550         General

551         Visit Charge

552         Hourly Charge

559         Other Skilled Nursing

56x               Medical Social Services

560         General

561         Visit Charge

562         Hourly Charge

569         Other Medical Social Services

57x               Home Health Aide (Home Health)

570         General

571         Visit Charge

572         Hourly Charge

579         Other Home Health Aide

58x               Other Visits (Home Health)

580         General

581         Visit Charge

582         Hourly Charge

583         Dietician

589         Other Home Health Visits

59x               Units of Service (Home Health)

590         General

599         Other Home Health Units

60x               Oxygen (Home Health)

600         General

601         Oxygen-State/Equip/Supply/Cont.

602         Oxygen-State/Equip/Supply/Under 1 LPM

603         Oxygen-State/Equip/Over 4 LPM

604         Oxygen-Portable Add-on

61x               Magnetic Resonance Imaging (MRI)

610         General

611         Brain (including brain stem)

612         Spinal Cord (including spine)

619         Other MRI

62x               Medical/Surgical Supplies (Extension of Revenue 27x)

621         Supplies Incidental to Radiology

622         Supplies Incidental to Other Diagnostic Services

623         Surgical Dressing

624         FDA Investigational Devices

63x               Drugs Requiring Specific Identification

630         General Classification

631         Single Source Drug

632         Multiple Source Drug

633         Restrictive Prescription

634         Erythropoietin (EPO) less than 10,000 units

635         Erythropoietin (EPO) more than 10,000 units

636         Drugs Requiring Detailed Coding

64x               Home IV Therapy Services

640         General Classification

641         Nonroutine Nursing, Central Line

642         IV Site Care, Central Line

643         IV Start/Change, Peripheral Line

644         Nonroutine Nursing, Peripheral Line

645         Training, Patient/Caregiver, Central Line

646         Training, Disabled Patient, Central Line

647         Training, Patient/Caregiver, Peripheral Line

648         Training, Disabled Patient, Peripheral Line

649         Other IV Therapy Services

65x               Hospice Services

650         General

651         Routine Home Care

652         Continuous Home Care

655         Inpatient Respite Care

656         General Inpatient Care

657         Physician Service

659         Other Hospice

66x               Respite Care (HHA Only)

660         General Classification

661         Hourly Charge/Skilled Nursing

662         Hourly Charge/Home Health Aide/Homemaker

67x               Outpatient Special Residence Charges

670         General

671         Hospital Based

672         Contracted

679         Other Special Residence Charges

70x               Cast Room

700         General

709         Other Cast Room

71x               Recovery Room

710         General

719         Other Recovery Room

72x               Labor Room/Delivery

720         General

721         Labor

722         Delivery

723         Circumcision

724         Birthing Center

729         False Labor

73x               EKG/ECG (Electrocardiogram)

730         General

731         Holter Monitor

732         Telemetry

739         Computerized EKG/ECG

74x               EEG (Electroencephalogram)

740         General

741         Electronystogmography

742         Diagnostic Sleep Disorder

749         Other EEG

75x               Gastro-Intestinal Services

750         General

759         Other Gastro-Intestinal

76x               Treatment/Observation Room

760         General

761         Treatment Room

762         Observation Room

769         Other Treatment Room

77x               Preventive Care Services

770         General Classification

771         Vaccine Administration

779         Other

79x               Lithotripsy

790         General

799         Other Lithotripsy

80x               Renal Dialysis- Inpatient

800         General

801         Inpatient Hemodialysis

802         Inpatient Peritoneal (Non-CAPD)

803         Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)

804         Inpatient Continuous Cycling Peritoneal Dialysis

809         Other Inpatient Dialysis

81x               Organ Acquisition

810         General

811         Living Donor

812         Cadaver Donor

813         Unknown Donor

814         Unsuccessful Organ Search-Donor Bank Charges

819         Other

82x              Hemodialysis- Outpatient or Home

820         General

821         Hemodialysis/Composite or Other Rate

822         Home Supplies (Not used in Michigan)

823         Home Equipment (Not used in Michigan)

824         Maintenance/100% (Not used in Michigan)

825         Support Services

829         Other Outpatient Hemodialysis

83x               Peritoneal Dialysis- Outpatient or Home

830         General

831         Peritoneal/Composite or Other Rate

832         Home Supplies (Not used in Michigan)

833         Home Equipment (Not used in Michigan)

834         Maintenance/100% (Not used in Michigan)

835         Support Services

839         Other Peritoneal Dialysis

84x         Continuous Ambulatory Peritoneal Dialysis (CAPD)- Outpatient/Home

840         General

841         CAPD/Composite or Other Rate

842         Home Supplies (Not used in Michigan)

843         Home Equipment (Not used in Michigan)

844         Maintenance/100% (Not used in Michigan)

845         Support Services

849         Other Outpatient CAPD

85x               Continuous Cycling Peritoneal Dialysis (CCPD)- Outpatient or Home

850         General

851         CCPD/Composite or Other Rate

852         Home Supplies (Not used in Michigan)

853         Home Equipment (Not used in Michigan)

854         Maintenance/100% (Not used in Michigan)

855         Support Services

859         Other CCPD

90x               Psychiatric/Psychological Treatments

900         General

901         Electroshock Treatment

902         Milieu Therapy

903         Play Therapy

904         Activity Therapy

909         Other

91x              Psychiatric/Psychological Services

910         General

911         Rehabilitation

912         Partial Hospitalization

914         Individual Therapy

915         Group Therapy

916         Family Therapy

917         Bio Feedback

918         Testing

919         Other

92x               Other Diagnostic Services

920         General

921         Peripheral Vascular Lab

922         Electromyelogram

923         Pap Smear

924         Allergy Test

925         Pregnancy Test

929         Other Diagnostic Services

94x               Other Therapeutic Services

940         General

941         Recreational Therapy

942         Education/Training/Diabetes Education

943         Cardiac Rehabilitation

944         Clinic-O/P Drug Rehabilitation

945         Clinic-O/P Alcohol Rehabilitation

946         Complex Medical Equipment-Routing

947         Complex Medical Equipment-Ancillary

949         Psoriasis Treatment Center

95x               Other Therapeutic Services (Extension of 94x)

950         Reserved

951         Athletic Training

952         Kinesiotherapy

96x              Prefessional Fees (Also See 97x and 98x)

960         General

961         Psychiatric

962         Opthalmology

963         Anesthesiologist (MD)

964         Anesthetist (CRNA)

969         Midwife

97x         Professional Fees (Extension of 96x)

971         Laboratory

972         Radiology-Diagnostic

973         Radiology-Therapeutic

974         Radiology-Nuclear Medicine

975         Operating Room

976         Respiratory Therapy

977         Physical Therapy

978         Occupational Therapy

979         Speech Pathology

98x         Professional Fees (Extension of 96x and 97x)

981         Emergency Room

982         Outpatient Services

983         Clinic

984         Medical Social Services

985         EKG

986         EEG

987         Hospital Visit

988         Consultation

989         Private Duty Nurse

99x         Patient Convenience Items

990         General

991         Cafeteria/Guest Tray

992         Private Linen Service

993         Telephone/Telegraph

994         TV/Radio

995         Non-Patient Room Rentals

996         Late Discharge Charge

997         Admission Kits

998         Beauty Shop/Barber

999         Other Patient Convenience Items

Sours: https://valuehealthcareservices.com/education/understanding-hospital-revenue-codes/

Revenue Codes - JE Part A

0001 Total Charges 001X Reserved for internal payer use 002X Health Insurance Prospective Payment System (HIPPS)
  • 0020-0021 Reserved
  • 0022 - Skilled Nursing Facility (SNF) PPS
  • 0023 - Home Health PPS
  • 0024 - Inpatient Rehabilitation Facility (IRF) PPS
  • 0025-0029 - Reserved
003X-009X 010X All-inclusive Rate
  • 0100 - All inclusive room and board plus ancillary
  • 0101 - All inclusive room and board
011X Room and Board Private (one bed)
  • 0110 - General
  • 0111 - Medical/Surgical/GYN
  • 0112 - OB
  • 0113 - Pediatric
  • 0114 - Psychiatric
  • 0115 - Hospice
  • 0116 - Detoxification
  • 0117 - Oncology
  • 0118 - Rehabilitation
  • 0119 - Other
012X Room and Board Semiprivate (two beds)
  • 0120 - General
  • 0121 - Medical/Surgical/GYN
  • 0122 - OB
  • 0123 - Pediatric
  • 0124 - Psychiatric
  • 0125 - Hospice
  • 0126 - Detoxification
  • 0127 - Oncology
  • 0128 - Rehabilitation
  • 0129 - Other
013X Room and Board (3 and 4 beds)
  • 0130 - General
  • 0131 - Medical/Surgical/GYN
  • 0132 - OB
  • 0133 - Pediatric
  • 0134 - Psychiatric
  • 0135 - Hospice
  • 0136 - Detoxification
  • 0137 - Oncology
  • 0138 - Rehabilitation
  • 0139 - Other
014X Room and Board Deluxe Private
  • 0140 - General
  • 0141 - Medical/Surgical/GYN
  • 0142 - OB
  • 0143 - Pediatric
  • 0144 - Psychiatric
  • 0145 - Hospice
  • 0146 - Detoxification
  • 0147 - Oncology
  • 0148 - Rehabilitation
  • 0149 - Other
015X Room and Board Ward
  • 0150 - General
  • 0151 - Medical/Surgical/GYN
  • 0152 - OB
  • 0153 - Pediatric
  • 0154 - Psychiatric
  • 0155 - Hospice
  • 0156 - Detoxification
  • 0157 - Oncology
  • 0158 - Rehabilitation
  • 0159 - Other
016X Other Room and Board
  • 0160 - General
  • 0164 - Sterile
  • 0167 - Self-care
  • 0169 - Other
017X Nursery
  • 0170 - General
  • 0171 - Newborn Level I
  • 0172 - Newborn Level II
  • 0173 - Newborn Level III
  • 0174 - Newborn Level IV
  • 0179 - Other
018X Leave of Absence
  • 0180 - General
  • 0182 - Patience convenience - charges billable
  • 0183 - Therapeutic leave
  • 0185 - Nursing home (for hospitalization)
  • 0189 - Other
019X Subacute Care
  • 0190 - General
  • 0191 - Level I
  • 0192 - Level II
  • 0193 - Level III
  • 0194 - Level IV
  • 0199 - Other
020X Intensive Care Unit
  • 0200 - General
  • 0201 - Surgical
  • 0202 - Medical
  • 0203 - Pediatric
  • 0204 - Psychiatric
  • 0206 - Intermediate ICU
  • 0207 - Burn Care
  • 0208 - Trauma
  • 0209 - Other
021X Coronary Care Unit
  • 0210 - General
  • 0211 - Myocardial Infarction
  • 0212 - Pulmonary Care
  • 0213 - Heart Transplant
  • 0214 - Intermediate CCU
  • 0219 - Other
022X Special Charges
  • 0220 - General
  • 0221 - Admission Charge
  • 0222 - Technical Support Charge
  • 0223 - UR Service Charge
  • 0224 - Late Discharge - Medically Necessary
  • 0229 - Other
023X Incremental Nursing Charge
  • 0230 - General
  • 0231 - Nursery
  • 0232 - OB
  • 0233 - ICU
  • 0234 - CCU
  • 0235 - Hospice
  • 0239 - Other
024X All-inclusive Ancillary
  • 0240 - General
  • 0241 - Basic
  • 0242 - Comprehensive
  • 0243 - Specialty
  • 0249 - Other
025X Pharmacy
  • 0250 - General
  • 0251 - Generic drugs
  • 0252 - Nongeneric drugs
  • 0253 - Take-home drugs
  • 0254 - Drugs incident to Other diagnostic services
  • 0255 - Drugs incident to radiology
  • 0256 - experimental drugs
  • 0257 - Nonprescription
  • 0258 - IV solutions
  • 0259 - Other
026X IV Therapy
  • 0260 - General
  • 0261 - Infusion pump
  • 0262 - Pharmacy services
  • 0263 - Drug/supply delivery
  • 0264 - Supplies
  • 0269 - Other
027X Medical/Surgical Supplies and Devices
  • 0270 - General
  • 0271 - Nonsterile
  • 0272 - Sterile
  • 0273 - Take-home supplies
  • 0274 - Prosthetic/orthotic devices
  • 0275 - Pacemaker
  • 0276 - Intracular lens
  • 0277 - Take-home oxygen
  • 0278 - Other implants
  • 0279 - Other
028X Oncology
  • 0280 - General
  • 0289 - Other
029X Durable Medical Equipment (Other than Renal)
  • 0290 - General
  • 0291 - Rental
  • 0292 - Purchase of new DME
  • 0293 - Purchase of used DME
  • 0294 - Supplies/Drugs for DME
  • 0299 - Other
030X Laboratory
  • 0300 - General
  • 0301 - Chemistry
  • 0302 - Immunology
  • 0303 - Renal patient (home)
  • 0304 - Nonroutine dialysis
  • 0305 - Hematology
  • 0306 - Bacteriology and Microbiology
  • 0307 - Urology
  • 0309 - Other
031X Laboratory Pathology
  • 0310 - General
  • 0311 - Cytology
  • 0312 - Histology
  • 0314 - Biopsy
  • 0319 - Other
032X Radiology Diagnostic
  • 0320 - General
  • 0321 - Angiocardiography
  • 0322 - Arthrography
  • 0323 - Arteriography
  • 0324 - Chest X-ray
  • 0329 - Other
033X Radiology Therapeutic and/of Chemotherapy Administration
  • 0330 - General
  • 0331 - Chemotherapy administration - injection
  • 0332 - Chemotherapy administration - oral
  • 0333 - Radiation therapy
  • 0335 - Chemotherapy administration - IV
  • 0339 - Other
034X Nuclear Medicine
  • 0340 - General
  • 0341 - Diagnostic
  • 0342 - Therapeutic
  • 0343 - Diagnostic radiopharmaceuticals
  • 0344 - Therapeutic radiopharmaceuticals
  • 0349 - Other
035X CT Scan
  • 0350 - General
  • 0351 - Head scan
  • 0352 - Body scan
  • 0359 - Other
036X Operating Room Services
  • 0360 - General
  • 0361 - Minor surgery
  • 0362 - Organ transplant - other than kidney
  • 0367 - Kidney transplant
  • 0369 - Other
037X Anesthesia
  • 0370 - General
  • 0371 - Incident to radiology
  • 0372 - incident to Other Diagnostic services
  • 0374 - Acupuncture
  • 0379 - Other
038X Blood and Blood Products
  • 0380 - General
  • 0381 - Packed red cells
  • 0382 - Whole blood and blood products
  • 0383 - Plasma
  • 0384 - Platelets
  • 0385 - Leukocytes
  • 0386 - Other components
  • 0387 - Other derivatives (cryoprecipitates)
  • 0389 - Other
039X Administration, Processing and Storage for Blood and Blood Components
  • 0390 - General
  • 0391 - Administration (e.g., transfusions)
  • 0392 - Processing and storage
  • 0399 - Other processing and storage
040X Other Imaging Services
  • 0400 - General
  • 0401 - Diagnostic mammography
  • 0402 - Ultrasound
  • 0403 - Screening mammography
  • 0404 - Positron Emission Tomography
  • 0409 - Other
041X Respiratory Services
  • 0410 - General
  • 0412 - Inhalation services
  • 0413 - Hyperbaric oxygen therapy
  • 0419 - Other
042X Physical Therapy
  • 0420 - General
  • 0421 - Visit charge
  • 0422 - Hourly charge
  • 0423 - Group rate
  • 0424 - Evaluation or reevaluation
  • 0429 - Other
043X Occupational Therapy
  • 0430 - General
  • 0431 - Visit charge
  • 0432 - Hourly charge
  • 0433 - Group rate
  • 0434 - Evaluation or reevaluation
  • 0439 - Other
044X Speech Therapy Language Pathology
  • 0440 - General
  • 0441 - Visit charge
  • 0442 - Hourly charge
  • 0443 - group rate
  • 0444 - Evaluation or reevaluation
  • 0449 - Other
045X Emergency Room
  • 0450 - General
  • 0451 - EMTALA emergency medical screening services
  • 0452 - ER beyond EMTALA screening
  • 0456 - Urgent care
  • 0459 - Other
046X Pulmonary Function
  • 0460 - General
  • 0469 - Other
047X Audiology
  • 0470 - General
  • 0471 - Diagnostic
  • 0472 - Treatment
  • 0479 - Other
048X Cardiology
  • 0480 - General
  • 0481 - Cardiac cath lab
  • 0482 - Stress test
  • 0483 - Echocardiology
  • 0489 - Other
049X Ambulatory Surgical Care
  • 0490 - General
  • 0499 - Other
050X Outpatient Services
  • 0500 - General
  • 0509 - Other
051X Clinic
  • 0510 - General
  • 0511 - Chronic pain center
  • 0512 - Dental clinic
  • 0513 - Psychiatric clinic
  • 0514 - OB/GYN clinic
  • 0515 - Pediatric clinic
  • 0516 - Urgent care clinic
  • 0517 - Family practice clinic
  • 0519 - Other
052X Freestanding Clinic
  • 0520 - General
  • 0521 - Clinic visit by member to RHC/FQHC
  • 0522 - Home visit by RHC/FQHC practitioner
  • 0523 - Family practice clinic
  • 0524 - Visit by RHC/FQHC practitioner to member in a Part A covered stay in SNF
  • 0525 - Visit by RHC/FQHC practitioner to member in a stay not covered by Part A in a
  • SNF, NF or ICF MR or other residential facility
  • 0526 - Urgent care clinic
  • 0527 - Visiting nurse services to member's home in a home health shortage area
  • 0528 - Visit by RHC/FQHC practitioner to other non-RHC/FQHC site (e.g., scene of accident)
  • 0529 - Other
053X Osteopathic Services
  • 0530 - General
  • 0531 - Osteopathic therapy
  • 0539 - Other
054X Ambulance
  • 0540 - General
  • 0541 - Supplies
  • 0542 - Medical transport
  • 0543 - Heart mobile
  • 0544 - Oxygen
  • 0545 - Air ambulance
  • 0546 - Neonatal ambulance
  • 0547 - Pharmacy
  • 0548 - EKG transmission
  • 0549 - Other
055X Skilled Nursing
  • 0550 - General
  • 0551 - Visit charge
  • 0552 - Hourly charge
  • 0559 - Other
056X Home Health Medical Social Services
  • 0560 - General
  • 0561 - Visit charge
  • 0562 - Hourly charge
  • 0569 - Other
057X Home Health Aide
  • 0570 - General
  • 0571 - Visit charge
  • 0572 - Hourly charge
  • 0579 - Other
058X Home Health Other Visits
  • 0580 - General
  • 0581 - Visit charge
  • 0582 - Hourly charge
  • 0583 - Assessment
  • 0589 - Other
059X Home Health Units of Service 060X Home Health Oxygen
  • 0600 - General
  • 0601 - Stat/Equip/Supply or contents
  • 0602 - Stat/Equip/Supply Under 1 LPM
  • 0603 - Stat/Equip Over 4 LPM
  • 0604 - Portable Add-on
  • 0609 - Other
061X Magnetic Resonance Technology (MRT)
  • 0610 - General
  • 0611 - Brain/brain stem
  • 0612 - Spinal cord/spine
  • 0614 - Other MRI
  • 0615 - Head and neck
  • 0616 - Lower extremities
  • 0618 - Other MRA
  • 0619 - Other MRT
062X Medical/Surgical Supplies - Extension of 027X
  • 0621 - Incident to Radiology
  • 0622 - Incident to Other Diagnostic services
  • 0623 - Surgical Dressings
  • 0624 - FDA investigational devices
063X Pharmacy - Extension of 025X
  • 0631 - Single source drug
  • 0632 - Multiple source drug
  • 0633 - Restrictive prescription
  • 0634 - Erythropoietin (EPO) less than 10,000 units
  • 0635- Erythropoietin (EPO) 10,000 or more units
  • 0636 - Drugs requiring detailed coding
  • 0637 - Self-administerable drugs
064X Home IV Therapy Services
  • 0640 - General
  • 0641 - Nonroutine nursing, central line
  • 0642 - IV site care, central line
  • 0643 - IV start/care, peripheral line
  • 0644 - Nonroutine nursing, peripheral line
  • 0645 - Training patient/caregiver, central line
  • 0646 - Training disabled patient, central line
  • 0647 - Training patient/caregiver, peripheral line
  • 0648 - Training disabled patient, peripheral line
  • 0649 - Other
065X Hospice Service
  • 0650 - General
  • 0651 - Routine home care
  • 0652 - Continuous home care
  • 0655 - Inpatient respite care
  • 0656 - General inpatient care (nonrespite)
  • 0657 - Physician services
  • 0658 - Hospice room and board - nursing facility
  • 0659 - Other
066X Respite Care
  • 0660 - General
  • 0661 - Hourly charge/nursing
  • 0662 - Hourly charge/aide/homemaker/companion
  • 0663 - daily respite charge
  • 0669 - Other
067X Outpatient Special Residence Charges
  • 0670 - General
  • 0671 - Hospital owned
  • 0672 - Contracted
  • 0679 - Other
068X Trauma Response
  • 0681 - Level I
  • 0682 - Level II
  • 0683 - Level III
  • 0684 - Level IV
  • 0689 - Other
069X 070X Cast Room 071X Recovery Room 072X Labor Room/Delivery
  • 0720 - General
  • 0721 - Labor
  • 0722 - Delivery
  • 0723 - Circumcision
  • 0724 - Birthing center
  • 0729 - Other
073X EKG/ECG Electrocardiogram
  • 0730 - General
  • 0731 - Holter monitor
  • 0732 - Telemetry
  • 0739 - Other
074X EEG Electroencephalogram 075X Gastrointestinal Services 076X Specialty Services
  • 0760 - General
  • 0761 - Treatment room
  • 0762 - Observation hours
  • 0769 - Other
077X Preventive Services
  • 0770 - General
  • 0771 - Vaccine administration
078X Telemedicine 079X Extra-Corporeal Shock Wave Therapy (formerly Lithotripsy) 080X Inpatient Renal Dialysis
  • 0800 - General
  • 0801 - Inpatient hemodialysis
  • 0802 - Inpatient peritoneal (non-CAPD)
  • 0803 - Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)
  • 0804 - Inpatient Continuous Cycling Peritoneal Dialysis (CCPD)
  • 0809 - Other
081X Acquisition of Body Components
  • 0810 - General
  • 0811 - Living donor
  • 0812 - Cadaver donor
  • 0813 - Unknown donor
  • 0814 - Unsuccessful organ search - donor bank charges
  • 0819 - Other
082X Hemodialysis - Outpatient or Home
  • 0820 - General
  • 0821 - Composite or other rate
  • 0822 - Home supplies
  • 0823 - Home equipment
  • 0824 - Maintenance/100%
  • 0825 - Support Services
  • 0829 - Other
083X Peritoneal Dialysis - Outpatient or Home
  • 0830 - General
  • 0831 - Composite or other rate
  • 0832 - Home supplies
  • 0833 - Home equipment
  • 0834 - Maintenance/100%
  • 0835 - Support Services
  • 0839 - Other
084X Continuous Ambulatory Peritoneal Dialysis (CAPD)- Outpatient or Home
  • 0840 - General
  • 0841 - Composite or other rate
  • 0842 - Home supplies
  • 0843 - Home equipment
  • 0844 - Maintenance/100%
  • 0845 - Support Services
  • 0849 - Other
085X Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home
  • 0850 - General
  • 0851 - Composite or other rate
  • 0852 - Home supplies
  • 0853 - Home equipment
  • 0854 - Maintenance/100%
  • 0855 - Support Services
  • 0859 - Other
086X Magnetoencephalography
  • 0860 - General
  • 0861 - MEG
087X 088X Miscellaneous Dialysis
  • 0880 - General
  • 0881 - Ultrafiltration
  • 0882 - Home dialysis aid visit
  • 0889 - Other
089X 090X Behavioral Health Treatments/Services (also see 091X, and extension of 090X)
  • 0900 - General
  • 0901 - Electroshock
  • 0902 - Milieu therapy
  • 0903 - Play therapy
  • 0904 - Activity therapy
  • 0905 - Intensive outpatient services - psychiatric
  • 0906 - Chemical dependency
  • 0907 - Community behavioral health program - day treatment
091X Behavioral Health Treatments/Services - Extension of 090X
  • 0911 - Rehabilitation
  • 0912 - Partial hospitalization - less intensive
  • 0913 - Partial hospitalization - intensive
  • 0914 - Individual therapy
  • 0915 - Group therapy
  • 0916 - Family therapy
  • 0917 - Biofeedback
  • 0918 - Testing
  • 0919 - Behavioral health treatments
092X Other Diagnostic Services
  • 0920 - General
  • 0921 - Peripheral vascular lab
  • 0922 - Electromyelogram
  • 0923 - Pap smear
  • 0924 - Allergy test
  • 0925 - Pregnancy test
  • 0929 - Other
093X Medical Rehabilitation Day Program
  • 0931 - Half day
  • 0932 - Full day
094X Other Therapeutic Services - See alos 095X
  • 0940 - General
  • 0941 - Recreational
  • 0942 - Education/training
  • 0943 - Cardiac rehabilitation
  • 0944 - Drug rehabilitation
  • 0945 - Alcohol rehabilitation
  • 0946 - Complex medical equipment - routine
  • 0947 - Complex medical equipment - ancillary
  • 0948 - Pulmonary rehabilitation
  • 0949 - Other
095X Other Therapeutic Services (Extension of 094X)
  • 0951 - Athletic training
  • 0952 - Kinesiotherapy
096X Professional Fees
  • 0960 - General
  • 0961 - Psychiatric
  • 0962 - Ophthalmology
  • 0963 - Anesthesiologist (MD)
  • 0964 - Anesthesiologist (CRNA)
  • 0969 - Other
097x Professional Fees (Extension of 096X)
  • 0971 - Laboratory
  • 0972 - Radiology - diagnostic
  • 0973 - Radiology - therapeutic
  • 0974 - Nuclear medicine
  • 0975 - Operating room
  • 0976 - Respiratory therapy
  • 0977 - Physical therapy
  • 0978 - Occupational therapy
  • 0979 - Speech pathology
098X Professional Fees (Extension of 096X and 097X)
  • 0981 - Emergency room
  • 0982 - Outpatient services
  • 0983 - Clinic
  • 0984 - Medical social services
  • 0985 - EKG
  • 0986 - EEG
  • 0987 - Hospital visit
  • 0988 - Consultation
  • 0989 - Private-duty nurse
099X Patient Convenience Items
  • 0990 - General
  • 0991 - Cafeteria/guest tray
  • 0992 - Private linen service
  • 0993 - Telephone/telegraph
  • 0994 - TV/radio
  • 0995 - Nonpatient room rentals
  • 0996 - Late discharge charge
  • 0997 - Admission kits
  • 0998 - Beauty shop/barber
  • 0999 - Other
100X Behavioral Health Accommodations
  • 1000 - General
  • 1001 - Residential treatment - psychiatric
  • 1002 - Residential treatment - chemical dependency
  • 1003 - Supervised living
  • 1004 - Halfway House
  • 1005 - Group Home
101X-209X 210X Alternative Therapy Services
  • 2100 - General
  • 2101 - Acupuncture
  • 2102 - Acupressure
  • 2103 - Massage
  • 2104 - Reflexology
  • 2105 - Biofeedback
  • 2106 - Hypnosis
  • 2109 - Other
211x - 300X 310X Adult Care
  • 3101 - adult daycare, medical and social - hourly
  • 3102 - Adult daycare, social - hourly
  • 3103 - Adult daycare, medical and social - daily
  • 3104 - Adult daycare, social - daily
  • 3105 - Adult foster care - daily
  • 3109 - Other
311X-999X
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Leave of Absence (LOA) and Hospital Repeat Admission Billing

End User Point and Click Agreement

CPT codes, descriptions and other data only are copyright 2012 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials (web pages, PDF documents, Excel documents, Word documents, text files, Power Point presentations and/or any Flash media) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt .

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U.S. Government Rights

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)(June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

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End User Point and Click Agreement

These materials contain Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. � 2012 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED “I ACCEPT”, YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

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  1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
  2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association website, http://www.ADA.org .
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    U.S. Government Rights. This product includes CDT, which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Dental Association, 211 East Chicago Avenue, Chicago, Illinois, 60611. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
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