What does a revenue code tell you?

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.

What CPT codes are used for palliative care?

A complete ROS is required for level 4 and 5 new patient home visits (commonly coded as 99344 and 99345), ALF visits (commonly coded as 99326 and 99327), and initial hospital visits (commonly coded as 99222, 99223).

What condition code is for not hospice related?

NOTE: that patient discharge status code 20 is not used on hospice claims. If the patient has died during the billing period, use codes 40, 41 or 42 as appropriate.

What is an example of a revenue code?

For example, the revenue code category 002-Health Insurance Prospective Payment System (HIPPS) is divided into revenue codes—0020-0021 Reserved, 0022 – Skilled Nursing Facility (SNF) PPS, 0023 – Home Health PPS, 0024 – Inpatient Rehabilitation Facility (IRF) PPS and 0025-0029 – Reserved.

What are healthcare revenue codes?

Maintained by the National Uniform Billing Committee (NUBC), revenue codes are defined by NUBC as “codes that identify specific accommodations, ancillary services, or unique billing calculations, or arrangements relevant to the claim.”

What are the hospice modifiers for Medicare?

Hospice Modifier GW The GW modifier indicates that the service rendered is unrelated to the patient’s terminal condition. All providers must submit this modifier when the service(s) provided are unrelated to the patient’s terminal condition.

Is palliative care billed the same as hospice?

But contrary to what some believe, palliative care is not the same as hospice. Unlike hospice, palliative care services do not focus on terminal illness and dying. Instead, they emphasize meeting the physical, emotional and spiritual needs of individuals and families facing serious, chronic or life-threatening illness.

What modifier do you use for hospice patients?

GV modifier
The GV modifier is used when a physician is providing a service that is related to the diagnosis for which a patient has been enrolled in hospice.

What are the condition codes?

Condition Codes

  • A – Serviceable issuable without qualification.
  • B – Serviceable issuable with qualification.
  • C – Serviceable priority issue.
  • D – Serviceable test modification.
  • E – Unserviceable limited restoration.
  • F – Unserviceable reparable.
  • G – Unserviceable incomplete.
  • H – Unserviceable condemned.

What is a Revenue Code for inpatient services?

For inpatient services, the revenue code identifies the department in which the service was given, the types of services provided, and the supplies used. The non -covered services defined in a member’s contract may include but are not limited to the following.

When is Revenue Code 762 acceptable?

• Revenue Code 762 is acceptable when an outpatient is being observed and treated in a non-ICU/CCU setting for a period of time or when a direct inpatient admission is not clear until the results of tests or procedures are confirmed and clinical care meets the inpatient admission criteria.

What is the Revenue Code for cardiac catheterization?

• Revenue Code 769 is only to be used when a highly intensive outpatient procedure is performed (i.e., cardiac catheterization, pacemaker procedures, etc.) and an ICU/CCU level of post procedure treatment and observation is necessary and appropriate. The diagnosis code should indicate the need for this level of care.

What Revenue Codes are available in field 44 of the UB-04?

The following chart identifies revenue codes that require a specific CPT/HCPCS code in field 44 of the UB-04. 0300 – 0309 Laboratory – Clinical Diagnostic Code for lab procedure performed 0310 – 0319 Laboratory – Pathology Code for pathology procedure performed 0320 – 0329 Radiology – Diagnostic Code for radiology procedure performed