UB04/CMS1450 Revenue Codes - Group 06
- 0600 General Classification UB04 Revenue Code
- 0601 Oxygen ? Stat Equip/Supply/ Content UB04 Revenue Code
- 0602 02/EQUIP/SUPPL/CONT UB04 Revenue Code
- 0603 Oxygen ? Stat Equip Supply/Over 4 LPM UB04 Revenue Code
- 0604 02/STAT EQUIP/OVER 4 LPM UB04 Revenue Code
- ABC Medical Services, Remedies, and Supply Codes - Group
- 060X Oxygen (Home Health) UB04 Revenue Code
- 0610 General Classification UB04 Revenue Code
- 0611 Brain (including Brainstem) UB04 Revenue Code
- 0612 Spinal Cord (including spine) UB04 Revenue Code
- 0613 02/STAT EQUIP/PORT ADD-ON: Reserved UB04 Revenue Code
- 0614 MRI - Other UB04 Revenue Code
- 0615 MRA - Head and Neck UB04 Revenue Code
- 0616 MRA - Lower Extremities UB04 Revenue Code
- 0617 02/STAT EQUIP/PORT ADD-ON: Reserved UB04 Revenue Code
- 0618 MRA - Other UB04 Revenue Code
- 0619 MRT- Other UB04 Revenue Code
- 061X 02/STAT EQUIP/PORT ADD-ON UB04 Revenue Code
- 0621 Supplies Incident to Radiology UB04 Revenue Code
- 0622 Supplies Incident to Other Diagnostic Services UB04 Revenue Code
- 0623 Surgical Dressings UB04 Revenue Code
- 0624 Investigational Device UB04 Revenue Code
- 062X Medical/Surgical Supplies - Extension of 027X UB04 Revenue Code
- 0630 Pharmacy - Extension of 025X: RESERVED (Use 0250 for General Classification) UB04 Revenue Code
- 0631 Single Source Drug UB04 Revenue Code
- 0632 Multiple Source Drug UB04 Revenue Code
- 0633 Restrictive Prescription UB04 Revenue Code
- 0634 Erythropoietin (EPO) less than 10,000 units UB04 Revenue Code
- 0635 Erythropoietin (EPO) 10,000 or more units UB04 Revenue Code
- 0636 Drugs Requiring Detailed Coding (a) UB04 Revenue Code
- 0637 Self-administrable Drugs (b) UB04 Revenue Code
- 063X Pharmacy - Extension of 025X UB04 Revenue Code
- 0640 General Classification UB04 Revenue Code
- 0641 Non-routine Nursing, Central Line UB04 Revenue Code
- 0642 IV Site Care, Central Line UB04 Revenue Code
- 0643 IV SITE CARE/CENTRAL UB04 Revenue Code
- 0644 Non-routine Nursing, Peripheral Line UB04 Revenue Code
- 0645 Training Patient/Caregiver, Central Line UB04 Revenue Code
- 0646 Training, Disabled Patient, Central Line UB04 Revenue Code
- 0647 Training Patient/Caregiver, Peripheral Line UB04 Revenue Code
- 0648 Training, Disabled Patient, Peripheral Line UB04 Revenue Code
- 0649 Other IV Therapy Services UB04 Revenue Code
- 064X Home IV Therapy Services UB04 Revenue Code
- 0650 General Classification UB04 Revenue Code
- 0651 Routine Home Care UB04 Revenue Code
- 0652 Continuous Home Care UB04 Revenue Code
- 0653 Hospice Services: RESERVED UB04 Revenue Code
- 0654 Hospice Services: RESERVED UB04 Revenue Code
- 0655 Inpatient Respite Care UB04 Revenue Code
- 0656 General Inpatient Care (non-respite) UB04 Revenue Code
- 0657 Physician Services UB04 Revenue Code
- 0658 Hospice Room & Board ? Nursing Facility UB04 Revenue Code
- 0659 Other Hospice UB04 Revenue Code
- 065X Hospice Services UB04 Revenue Code
- 0660 General Classification UB04 Revenue Code
- 0661 Hourly Charge/ Nursing UB04 Revenue Code
- 0662 Hourly Charge/ Aide/Homemaker/Companion UB04 Revenue Code
- 0663 Daily Respite Charge UB04 Revenue Code
- 0669 Other Respite Care UB04 Revenue Code
- 066X Respite Care (HHA Only) UB04 Revenue Code
- 0670 General Classification UB04 Revenue Code
- 0671 Hospital Based UB04 Revenue Code
- 0672 Contracted UB04 Revenue Code
- 0679 OP SPEC RES/CONTRACTED UB04 Revenue Code
- 067X Outpatient Special Residence Charges UB04 Revenue Code
- 0680 Not Used UB04 Revenue Code
- 0681 Level I UB04 Revenue Code
- 0682 Level II UB04 Revenue Code
- 0683 Level III UB04 Revenue Code
- 0684 Level IV UB04 Revenue Code
- 0689 Other Trauma Response UB04 Revenue Code
- 068X Trauma Response UB04 Revenue Code
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- ABC Medical Services, Remedies, and Supply Codes - Group
- 069X Not Assigned UB04 Revenue Code
Back to UB04/CMS1450 Revenue Codes Groups List
What are UB04 Revenue Codes?
Form CMS-1450 (UB-04)This form, also known as the UB-04, is a uniform institutional provider bill suitable for use in billing multiple third party payers. Because it serves many payers, a particular payer may not need some data elements. The National Uniform Billing Committee (NUBC) maintains lists of approved coding for the form. All items on Form CMS-1450 are described. The FI must be able to capture all NUBC-approved input data described in section 75 (of the Medicare Claims Processing Manual Chapter 25) for audit trail purposes and be able to pass all data to other payers with whom it has a coordination of benefits agreement.
CMS1450/UB04 Field: 42 - Revenue Code (Required)
The provider enters the appropriate revenue codes to identify specific accommodation and/or ancillary charges. It must enter the appropriate numeric revenue code on the adjacent line in FL 42 to explain each charge in FL 47. Additionally, there is no fixed "Total" line in the charge area. The provider must enter revenue code 0001 instead in FL 42. Thus, the adjacent charges entry in FL 47 is the sum of charges billed. This is the same line on which non-covered charges, in FL 48, if any, are summed. To assist in bill review, the provider must list revenue codes in ascending numeric sequence and not repeat on the same bill to the extent possible. To limit the number of line items on each bill, it should sum revenue codes at the "zero" level to the extent possible.
Source: Adapted from the Medicare Claims Processing Manual Chapter 25 - Completing and Processing the Form CMS-1450 Data Set
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