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.
Hospitals run on three sets of universal codes:
– ICD-10 (International Classification of Diseases)– for diagnoses
– CPT (Current Procedural Terminology) – for procedures
– HCPCS (Healthcare Common Procedure Coding System) – 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. There is a tremendous role seen in the Revenue Codes for 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 the standard for hospitals.