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Chargemaster Toolkit UB-04 Revenue Codes

Revenue CodeShort DescriptionLong Description
0001Total ChargeTotal Charge
0022SNF PPS Claim - TOB 21XHealth Insurance Prospective Payment System (HIPPS) - Skilled Nursing Facility
0023HH PPS Claim - TOB 32X & 33XHealth Insurance Prospective Payment System (HIPPS) - Home Health
0024IP Rehab PPSHealth Insurance Prospective Payment System (HIPPS) - Inpatient Rehabilitation Facility
0100R&B - All Inclusive - Plus AncillaryAll Inclusive Rate - Room and Board Plus Ancillary
0101R&B - All InclusiveAll Inclusive Rate - Room and Board
0110R&B - Private - GenRoom & Board - Private (One Bed) - General Classification
0111R&B - Private - Med/Surg/GYNRoom & Board - Private (One Bed) - Medical/Surgical/GYN
0112R&B - Private - OBRoom & Board - Private (One Bed) - Obstetrics (OB)
0113R&B - Private - PediRoom & Board - Private (One Bed) - Pediatric
0114R&B - Private - PsychRoom & Board - Private (One Bed) - Psychiatric
0115R&B - Private - HospiceRoom & Board - Private (One Bed) - Hospice
0116R&B - Private - DetoxRoom & Board - Private (One Bed) - Detoxification
0117R&B - Private - OncologyRoom & Board - Private (One Bed) - Oncology
0118R&B - Private - RehabRoom & Board - Private (One Bed) - Rehabilitation
0119R&B - Private - OtherRoom & Board - Private (One Bed) - Other
0120R&B - Semiprivate - GeneralRoom & Board - Semi-private (Two Beds) - General Classification
0121R&B - Semiprivate - Med/Surg/GynRoom & Board - Semi-private (Two Beds) - Medical/Surgical/GYN
0122R&B - Semiprivate - OBRoom & Board - Semi-private (Two Beds) - Obstetrics (OB)
0123R&B - Semiprivate - PediRoom & Board - Semi-private (Two Beds) - Pediatric
0124R&B - Semiprivate - PsychRoom & Board - Semi-private (Two Beds) - Psychiatric
0125R&B - Semiprivate - HospiceRoom & Board - Semi-private (Two Beds) - Hospice
0126R&B - Semiprivate - DetoxRoom & Board - Semi-private (Two Beds) - Detoxification
0127R&B - Semiprivate - OncologyRoom & Board - Semi-private (Two Beds) - Oncology
0128R&B - Semiprivate - RehabRoom & Board - Semi-private (Two Beds) - Rehabilitation
0129R&B - Semiprivate - OtherRoom & Board - Semi-private (Two Beds) - Other
0130R&B - Semiprivate, 3 & 4 beds - GenRoom & Board - Three and Four Beds - General Classification
0131R&B - SP_MS/Surg/GYN/ 3&4 bedsRoom & Board - Three and Four Beds - Medical/Surgical/GYN
0132R&B - SP_OB/ 3 & 4 bedsRoom & Board - Three and Four Beds - Obstetrics (OB)
0133R&B - SP_Peds/ 3 & 4 bedsRoom & Board - Three and Four Beds - Pediatric
0134R&B - SP_Psych/ 3 & 4 bedsRoom & Board - Three and Four Beds - Psychiatric
0135R&B - SP_Hospice/ 3& 4 bedsRoom & Board - Three and Four Beds - Hospice
0136R&B - SP_Detox/ 3 & 4 bedsRoom & Board - Three and Four Beds - Detoxification
0137R&B - SP_Oncology/ 3 & 4 bedsRoom & Board - Three and Four Beds - Oncology
0138R&B - SP_ Rehab/ 3 & 4 bedsRoom & Board - Three and Four Beds - Rehabilitation
0139R&B - SP_Other, 3 & 4 bedsRoom & Board - Three and Four Beds - Other
0140R&B - Private/Deluxe_GenRoom & Board - Deluxe Private - General Classification
0141R&B - PD_MS/Surg/GYNRoom & Board - Deluxe Private - Medical/Surgical/GYN
0142R&B - PDeluxe_OBRoom & Board - Deluxe Private - Obstetrics (OB)
0143R&B - PD_PediRoom & Board - Deluxe Private - Pediatric
0144R&B - PD_PsychRoom & Board - Deluxe Private - Psychiatric
0145R&B - PD_HospiceRoom & Board - Deluxe Private - Hospice
0146R&B - PD_DetoxRoom & Board - Deluxe Private - Detoxification
0147R&B - PD_OncologyRoom & Board - Deluxe Private - Oncology
0148R&B - PD_ RehabRoom & Board - Deluxe Private - Rehabilitation
0149R&B - Other Private DeluxeRoom & Board - Deluxe Private - Other
0150R&B - Ward, GeneralRoom & Board - Ward - General Classification
0151R&B - Med-sur-Gy/WardRoom & Board - Ward - Medical/Surgical/GYN
0152R&B - OB/WardRoom & Board - Ward - Obstetrics (OB)
0153R&B - Peds/WardRoom & Board - Ward - Pediatrics
0154R&B - Psych/WardRoom & Board - Ward - Psychiatric
0155R&B - Hospice/WardRoom & Board - Ward - Hospice
0156R&B - Detox/WardRoom & Board - Ward - Detoxification
0157R&B - Oncology/WardRoom & Board - Ward - Oncology
0158R&B - Rehab/WardRoom & Board - Ward - Rehabilitation
0159R&B - Other/WardRoom & Board - Ward - Other
0160R&B - Other_GenRoom & Board - Other - General Classification
0161ROOM & BOARD - HOSPITAL AT HOMEROOM & BOARD - HOSPITAL AT HOME
0164R&B - Sterile EnvironmentRoom & Board - Other - Sterile Environment
0167R&B - Self CareRoom & Board - Other - Self Care
0169R&B - OtherRoom & Board - Other - Other
0170Nursery - GeneralNursery - General Classification
0171Newborn-Level INursery - Newborn - Level I
0172Newborn-Level IINursery - Newborn - Level II
0173Newborn-Level IIINursery - Newborn - Level III
0174Newborn-Level IVNursery - Newborn - Level IV
0179Nursery/OtherNursery - Other
0180LOA - GeneralLeave of Absence - General Classification
0182LOA_Pt ConvenienceLeave of Absence - Patient Convenience
0183LOA_TherapeuticLeave of Absence - Therapeutic Leave
0185LOA_HospitalizationLeave of Absence - Nursing Home (for Hospitalization)
0189LOA_OtherLeave of Absence - Other
0190Subacute - GeneralSubacute Care - General Classification
0191Subacute/ Level ISubacute Care - Level I
0192Subacute/ Level IISubacute Care - Level II
0193Subacute/ Level IIISubacute Care - Level III
0194Subacute/ Level IVSubacute Care - Level IV
0199Subacute/ OtherSubacute Care - Other
0200ICU - GeneralIntensive Care Unit - General Classification
0201ICU/ SurgicalIntensive Care Unit - Surgical
0202ICU/ MedicalIntensive Care Unit - Medical
0203ICU/ PedsIntensive Care Unit - Pediatric
0204ICU/ PsychIntensive Care Unit - Psychiatric
0206ICU/ IntermediateIntensive Care Unit - Intermediate ICU
0207ICU/ Burn CareIntensive Care Unit - Burn Care
0208ICU/ TraumaIntensive Care Unit - Trauma
0209ICU/ OtherIntensive Care Unit - Other
0210CCU - GeneralCoronary Care Unit - General Classification
0211CCU/ MICoronary Care Unit - Myocardial Infarction
0212CCU/ PulmonaryCoronary Care Unit - Pulmonary Care
0213CCU/ TransplantCoronary Care Unit - Heart Transplant
0214CCU/ IntermediateCoronary Care Unit - Intermediate CCU
0219CCU/ OtherCoronary Care Unit - Other
0220Special Chgs_GenSpecial Charges - General Classification
0221Admit ChgSpecial Charges - Admission Charge
0222Tech Suppt ChgSpecial Charges - Technical Support Charge
0223UR ChgSpecial Charges - U.R. Service Charge
0224Late DC/Med NecSpecial Charges - Late Discharge, Medically Necessary
0229Othr Spec ChgSpecial Charges - Other
0230Nursing Increm/ GenIncremental Nursing Charge - General Classification
0231Nurs Incr/NurseryIncremental Nursing Charge - Nursery
0232Nurs Incr/OBIncremental Nursing Charge - OB
0233Nurs Incr/ ICUIncremental Nursing Charge - ICU
0234Nurs Incr/ CCUIncremental Nursing Charge - CCU
0235Nurs Incr/ HospiceIncremental Nursing Charge - Hospice
0239Nur Incr/ OtherIncremental Nursing Charge - Other
0240All Incl AncillaryAll Inclusive Ancillary - General Classification
0241InclAncillary_BasicAll Inclusive Ancillary - Basic
0242Incl Ancillary_ComprehAll Inclusive Ancillary - Comprehensive
0243Incl Ancillary_SpecialtyAll Inclusive Ancillary - Specialty
0249All Incl Ancillary/ OtherAll Inclusive Ancillary - Other
0250Drugs_GenPharmacy - General Classification
0251Drugs_ GenericPharmacy - Generic Drugs
0252Drugs_NongenericPharmacy - Non-generic Drugs
0253Drugs/Take HomePharmacy - Take Home Drugs
0254Drugs/ Incid to DxPharmacy - Drugs Incident To Other Diagnostic Services
0255Drugs/ Incident RadPharmacy - Drugs Incident To Radiology
0256Drugs/ ExperimPharmacy - Experimental Drugs
0257Drugs/ NonscriptPharmacy - Nonprescription
0258IV SolutionPharmacy - IV Solutions
0259Drugs - OtherPharmacy - Other
0260IV Tx_GenIV Therapy - General Classification
0261IV Tx_ Infsn PumpIV Therapy - Infusion Pump
0262IV Tx_PharmIV Therapy/Pharmacy Services
0263IV Tx_Drug DelivIV Therapy/Drug/Supply Delivery
0264IV Tx_SuppliesIV Therapy/Supplies
0269IV Tx_OtherIV Therapy - Other
0270Med-Surg Supplies/GenMedical/Surgical Supplies and Devices - General Classification
0271Non-Sterile SupplyMedical/Surgical Supplies and Devices - Non-sterile Supply
0272Sterile SupplyMedical/Surgical Supplies and Devices - Sterile Supply
0273Take Home SupplyMedical/Surgical Supplies and Devices - Take Home Supplies
0274Prosthetics_OrthoticsMedical/Surgical Supplies and Devices - Prosthetic/Orthotic Devices
0275PacemakerMedical/Surgical Supplies and Devices - Pacemaker
0276IOLMedical/Surgical Supplies and Devices - Intraocular Lens
0277O2_Take HomeMedical/Surgical Supplies and Devices - Oxygen - Take Home
0278Supply_ImplantsMedical/Surgical Supplies and Devices - Other Implants
0279Supply_OtherMedical/Surgical Supplies and Devices - Other
0280Oncology_GenOncology - General Classification
0289Oncology_OtherOncology - Other
0290DME_GenDurable Medical Equipment (other than renal) - General Classification
0291DME_RentalDurable Medical Equipment (other than renal) - Rental
0292DME_New PurchaseDurable Medical Equipment (other than renal) - Purchase of new DME
0293DME_Used PurchaseDurable Medical Equipment (other than renal) - Purchase of used DME
0294DME_Supplies/DrugsDurable Medical Equipment (other than renal) - Supplies/Drugs for DME
0299DME_OtherDurable Medical Equipment (other than renal) - Other
0300Lab - GeneralLaboratory - General Classification
0301Lab - ChemistryLaboratory - Chemistry
0302Lab - ImmunologyLaboratory - Immunology
0303Lab - Home RentalLaboratory - Renal Patient (Home)
0304Lab - NR DialysisLaboratory - Non-routine Dialysis
0305Lab - HematologyLaboratory - Hematology
0306Lab - Bact- MicroLaboratory - Bacteriology & Microbiology
0307Lab - UrologyLaboratory - Urology
0309Lab - OtherLaboratory - Other
0310Lab Path - GeneralLaboratory Pathology - General Classification
0311Lab Path - CytologyLaboratory Pathology - Cytology
0312Lab Path - HistologyLaboratory Pathology - Histology
0314Lab Path - BiopsyLaboratory Pathology - Biopsy
0319Lab Path - OtherLaboratory Pathology - Other
0320Rad - Dx - GeneralRadiology - Diagnostic - General Classification
0321Rad - Dx - AngiocardiographyRadiology - Diagnostic - Angiocardiography
0322Rad - Dx - ArthrographyRadiology - Diagnostic - Arthrography
0323Rad - Dx - ArteriographyRadiology - Diagnostic - Arteriography
0324Rad - Dx - C XRRadiology - Diagnostic - Chest X-Ray
0329Rad - Dx - OtherRadiology - Diagnostic - Other
0330Rad - Therapeutic - GeneralRadiology - Therapeutic and/or Chemotherapy Administration - General Classification
0331Chemo - InjectedRadiology - Therapeutic - Chemotherapy Administration - Injected
0332Chemo - OralRadiology - Therapeutic - Chemotherapy Administration - Oral
0333Radiation TherapyRadiology - Therapeutic - Radiation Therapy
0335Chemo - IVRadiology - Therapeutic - Chemotherapy Administration - IV
0339Rad - Therapeutic - OtherRadiology - Therapeutic - Other
0340Nuclear Med - GeneralNuclear Medicine - General Classification
0341Nuclear Med - Diagnostic ProceduresNuclear Medicine - Diagnostic Procedures
0342Nuclear Med - Therapeutic ProceduresNuclear Medicine - Therapeutic Procedures
0343Diagnostic RadiopharmaceuticalsNuclear Medicine - Diagnostic Radiopharmaceuticals
0344Therapeutic RadiopharmaceuticalsNuclear Medicine - Therapeutic Radiopharmaceuticals
0349Nuclear Med - OtherNuclear Medicine - Other
0350CT Scan - GeneralCT Scan - General Classification
0351CT Scan - HeadCT Scan - Head Scan
0352CT Scan - Body CT Scan - Body Scan
0359CT Scan - Other CT Scan - Other
0360OR - GeneralOperating Room Services - General Classification
0361OR - Minor Operating Room Services - Minor Surgery
0362OR - Organ Transplant, not KidneyOperating Room Services - Organ transplant - Other Than Kidney
0367OR - Kidney TransplantOperating Room Services - Kidney Transplant
0369OR - OtherOperating Room Services - Other
0370Anesthesia - GeneralAnesthesia - General Classification
0371Anesthesia - Incident to RadiologyAnesthesia - Incident to Radiology
0372Anesthesia - Incident to Other DxAnesthesia - Incident to Other Diagnostic Services
0374Anesthesia - AcupunctureAnesthesia - Acupuncture
0379Anesthesia - OtherAnesthesia - Other
0380Blood - GeneralBlood and Blood Components - General Classification
0381Blood - Packed Red CellsBlood and Blood Components - Packed Red Cells
0382Blood - Whole BloodBlood and Blood Components - Whole Blood
0383Blood - PlasmaBlood and Blood Components - Plasma
0384Blood - PlateletsBlood and Blood Components - Platelets
0385Blood - LeukocytesBlood and Blood Components - Leukocytes
0386Blood - Other ComponentsBlood and Blood Components - Other Blood Components
0387Blood - Other Derivatives (Cryopricipitates)Blood and Blood Components - Other Derivatives (Cryoprecipitates)
0389Blood - Other BloodBlood and Blood Components - Other
0390Blood/Components - General ClassificationAdministration, Processing, and Storage for Blood and Blood Components - General Classification
0391Blood Administration (e.g., Transfusion)Administration, Processing, and Storage for Blood and Blood Components - Administration (e.g., Transfusion)
0392Processing and StorageAdministration, Processing, and Storage for Blood and Blood Components - Processing and Storage
0399Blood/Components - Other Processing & StorageAdministration, Processing, and Storage for Blood and Blood Components - Other Blood Handling
0400Imaging Service - GeneralOther Imaging Services - General Classification
0401Dx MammographyOther Imaging Services - Diagnostic Mammography
0402UltrasoundOther Imaging Services - Ultrasound
0403Screening MammographyOther Imaging Services - Screening Mammography
0404Positron Emission (PET) ScanOther Imaging Services - Positron Emission Tomography
0409Other ImagingOther Imaging Services - Other
0410Respiratory Service - GeneralRespiratory Services - General Classification
0412Resp - Inhalation ServiceRespiratory Services - Inhalation Services
0413Resp - Hyperbaric O2 (HBO) TherapyRespiratory Services - Hyperbaric Oxygen Therapy
0419Respiratory Service - OtherRespiratory Services - Other
0420PT - GeneralPhysical Therapy - General Classification
0421PT - Visit ChargePhysical Therapy - Visit Charge
0422PT - Hourly ChargePhysical Therapy - Hourly Charge
0423PT - Group RatePhysical Therapy - Group Rate
0424PT - Eval or Re-evaluationPhysical Therapy - Evaluation or Re-evaluation
0429PT - OtherPhysical Therapy - Other
0430OT - GeneralOccupational Therapy - General Classification
0431OT - Visit ChargeOccupational Therapy - Visit Charge
0432OT - Hourly ChargeOccupational Therapy - Hourly Charge
0433OT - Group RateOccupational Therapy - Group Rate
0434OT - Eval or Re-evaluationOccupational Therapy - Evaluation or Reevaluation
0439OT - OtherOccupational Therapy - Other
0440Speech Pathol - GeneralSpeech Therapy - Language Pathology - General Classification
0441Speech Path - Visit ChargeSpeech Therapy - Language Pathology - Visit Charge
0442Speech Path - Hourly ChargeSpeech Therapy - Language Pathology - Hourly Charge
0443Speech Path - Group RateSpeech Therapy - Language Pathology - Group Rate
0444Speech Path - Eval or Re-evaluationSpeech Therapy - Language Pathology - Evaluation or Reevaluation
0449Speech Path - OtherSpeech Therapy - Language Pathology - Other
0450ER - GeneralEmergency Room - General Classification
0451ER - EMTALAEmergency Room - EMTALA Emergency Medical Screening Services
0452ER > EMTALAEmergency Room - Beyond EMTALA Screening
0456ER - UrgicareEmergency Room - Urgent Care
0459ER - OtherEmergency Room - Other
0460Pulmonary Function - GeneralPulmonary Function - General Classification
0469Pulmonary Function - OtherPulmonary Function - Other
0470Audiology - GeneralAudiology - General Classification
0471Audiology - DiagnosticAudiology - Diagnostic
0472Audiology - TreatmentAudiology - Treatment
0479Audiology_OtherAudiology - Other
0480Cardiology - GeneralCardiology - General Classification
0481Cardiology - Cardiac Cath labCardiology - Cardiac Cath Lab
0482Cardiology - Stress TestCardiology - Stress Test
0483Cardiology - EchocardiologyCardiology - Echocardiology
0489Cardiology - OtherCardiology - Other
0490Ambulatory Surgery - GeneralAmbulatory Surgical Care - General Classification
0499Ambulatory Surgery - OtherAmbulatory Surgical Care - Other
0500Outpatient Services - GeneralOutpatient Services - General Classification
0509Outpatient Services - OtherOutpatient Services - Other
0510Clinic - GeneralClinic - General Classification
0511Clinic - Chronic Pain CenterClinic - Chronic Pain Center
0512Clinic - DentalClinic - Dental
0513Clinic - PsychiatricClinic - Psychiatric
0514Clinic - OB-GYNClinic - OB-GYN
0515Clinic - PediatricClinic - Pediatric
0516Clinic - Urgent CareClinic - Urgent Care
0517Clinic - Family PracticeClinic - Family Practice
0519Clinic - OtherClinic - Other
0520Freestanding Clinic - GeneralFree-Standing Clinic - General Classification
0521Freestanding Clinic - RHC/FQHC - ClinicFree-Standing Clinic - Clinic visit by member to RHC/FQHC
0522Freestanding Clinic - RHC/FQHC- HomeFree-Standing Clinic - Home visit by RHC/FQHC practitioner
0523Free-Standing Clinic - Family Practice ClinicFree-Standing Clinic - Family Practice
0524RHC/FQHC Visit - SNF (Part A)Free-Standing Clinic - Visit by RHC/FQHC practitioner to a member in a SNF or Skilled Swing Bed in a covered Part A stay
0525RHC/FQHC Visit - SNF (OTHER)/NF/ICF/MRFree-Standing Clinic - Visit by RHC/FQHC practitioner to a member in a SNF (not in a covered Part A stay) or NF or ICF MR or other residential facility
0526Free-Standing Clinic - Urgent CareFree-Standing Clinic - Urgent Care
0527RHC/FQHC Visiting Nurse Service(s) - Home (HSA)Free-Standing Clinic - RHC/FQHC Visiting Nurse Service(s) to a member's home when in a home health shortage area
0528RHC/FQHC Visit - Other SiteFree-Standing Clinic - Visit by RHC/FQHC practitioner to other non RHC/FQHC site (e.g., scene of accident)
0529Free-Standing Clinic - Other FreestandingFree-Standing Clinic - Other
0530Osteopathic - GeneralOsteopathic Services - General Classification
0531Osteopathic TherapyOsteopathic Services - Osteopathic Therapy
0539Osteopathic - OtherOsteopathic Services - Other
0540Ambulance - GeneralAmbulance - General Classification
0541Ambulance - SuppliesAmbulance - Supplies
0542Ambulance - Medical TransportAmbulance - Medical Transport
0543Ambulance - Heart MobileAmbulance - Heart Mobile
0544Ambulance - OxygenAmbulance - Oxygen
0545Ambulance - Air AmbulanceAmbulance - Air Ambulance
0546Ambulance - Neonatal ServicesAmbulance - Neonatal Ambulance
0547Ambulance - PharmacyAmbulance - Pharmacy
0548Ambulance - Telephone EKG TransmissionAmbulance - EKG Transmission
0549Ambulance - OtherAmbulance - Other
0550Skilled Nursing - GeneralSkilled Nursing - General Classification
0551Skilled Nursing - Visit ChargeSkilled Nursing - Visit Charge
0552Skilled Nursing - Hourly ChargeSkilled Nursing - Hourly Charge
0559Skilled Nursing - OtherSkilled Nursing - Other
0560Med Social Services - GeneralHome Health (HH) - Medical Social Services - General Classification
0561Med Soc Servs/VisitHome Health (HH) - Medical Social Services - Visit Charge
0562Med Soc Servs/HourHome Health (HH) - Medical Social Services - Hourly Charge
0569Med Soc Servs/OtherHome Health (HH) - Medical Social Services - Other
0570Aide/Home HealthHome Health (HH) Aide - General Classification
0571Aide/Home Hlth/VisitHome Health (HH) Aide - Visit Charge
0572Aide/Home Hlth/HourHome Health (HH) Aide - Hourly Charge
0579Aide/Home Hlth/OtherHome Health (HH) Aide - Other
0580HH visit - GeneralHome Health (HH) - Other Visits - General Classification
0581HH Visit ChgHome Health (HH) - Other Visits - Visit Charge
0582HH Hourly CHGHome Health (HH) - Other Visits - Hourly Charge
0583HH AssessmentHome Health (HH) - Other Visits - Assessment
0589HH Visit - OtherHome Health (HH) - Other Visits - Other
0590HH Service Unit - GenHome Health (HH) Units of Service - General Classification
0600O2/Home HealthHome Health (HH) - Oxygen - General Classification
0601Os/Stat Equip/Suppl/ContHome Health (HH) - Oxygen - Stat Equip/Supply/Content
0602O2/Stat Equip/Under 1 LPMHome Health (HH) - Oxygen - Stat Equip/Supply<1 LPM
0603O2/Stat Equip/Over 4 LPMHome Health (HH) - Oxygen - Stat Equip/Supply>4 LPM
0604O2/Portable Add-onHome Health (HH) - Oxygen - Portable Add-on
0609HH - Oxygen, OtherHome Health (HH) - Oxygen - Other
0610MRT - General (Magnetic Resonance Technology)Magnetic Resonance Technology (MRT) - General Classification
0611MRI - Brain (including Brainstem)Magnetic Resonance Technology (MRT) - Brain/Brainstem
0612MRI - Spinal Cord (including Spine)Magnetic Resonance Technology (MRT) - Spinal Cord/Spine
0614MRI - Other (Magnetic Resonance Imaging)Magnetic Resonance Technology (MRT) - MRI - Other
0615MRA - Head and Neck (Magnetic Resonance Angiography)Magnetic Resonance Technology (MRT) - MRA - Head and Neck
0616MRA - Lower Extremities (Magnetic Resonance Angiography)Magnetic Resonance Technology (MRT) - MRA - Lower Extremities
0618MRA - Other (Magnetic Resonance Angiography)Magnetic Resonance Technology (MRT) - MRA - Other
0619MRT - Other (Magnetic Resonance Technology)Magnetic Resonance Technology (MRT) - Other
0621Med/Surg Supplies - Incident to RadMedical Surgical Supplies - Incident to Radiology
0622Med/Surg Supplies - Incident to Other DxMedical Surgical Supplies - Incident to Other Diagnostic Services
0623Med/Surg Supplies - Surgical DressingsMedical Surgical Supplies - Surgical Dressings
0624MS Supplies - FDA Investigational DeviceMedical Surgical Supplies - FDA Investigational Devices
0630Drugs Req Specific ID - GeneralDrugs requiring specific identification-general classification
0631Drugs - Single Source DrugPharmacy - Single Source Drug
0632Drugs - Multiple Source DrugPharmacy - Multiple Source Drug
0633Drugs - Restrictive PrescriptionPharmacy - Restrictive Prescription
0634Drugs - EPO <10,000 unitsPharmacy - Erythropoietin (EPO) less than 10,000 units
0635Drugs - EPO 10,000 units or >Pharmacy - Erythropoietin (EPO) 10,000 or more units
0636Drugs/ Detailed Coding RequiredPharmacy - Drugs Requiring Detailed Coding
0637Self-Administrable DrugsPharmacy - Self-administrable Drugs
0640Home IV Therapy - GeneralHome IV Therapy Services - General Classification
0641Home IV Tx -NR Central LineHome IV Therapy Services - Non-routine Nursing, Central Line
0642Home IV Site Care - Central LineHome IV Therapy Services - IV Site Care, Central Line
0643Home IV Start/Chg Periph LineHome IV Therapy Services - IV Start/Care, Peripheral Line
0644Home IV, NR Periph LineHome IV Therapy Services - Non-routine Nursing, Peripheral Line
0645Home IV Train - Pt/CG Central LHome IV Therapy Services - Training, Patient/Caregiver, Central Line
0646Home IV Train - D Pt Central LHome IV Therapy Services - Training, Disabled Patient, Central Line
0647Home IV Train - Pt/CG Periph LHome IV Therapy Services - Training, Patient/Caregiver, Peripheral Line
0648Home IV Train Disabl Pt - Periph LHome IV Therapy Services - Training, Disabled Patient, Peripheral Line
0649Other Home IV Therapy SvcHome IV Therapy Services - Other
0650Hospice - GeneralHospice Services - General Classification
0651Hospice - Routine Home CareHospice Services - Routine Home Care
0652Hospice - Continuous Home CareHospice Services - Continuous Home Care
0655Hospice - IP RespiteHospice Services - Inpatient Respite Care
0656Hospice - IP Non-RespiteHospice Services - General Inpatient Care (non-respite)
0657Hospice - Physician ServiceHospice Services - Physician Services
0658Hospice - R&B - Nursing FacilityHospice Services - Hospice Room & Board - Nursing Facility
0659Hospice/OtherHospice Services - Other
0660NH Respite Care - General ClassRespite Care - General Classification
0661NH Respite - Hourly Chg/NursingRespite Care - Hourly Charge/Nursing
0662NH Respite - Aid/Hmkr/Companion Hourly ChgRespite Care - Hourly Charge/Aide/Homemaker/Companion
0663NH Respite Care - Daily ChargeRespite Care - Daily Respite Charge
0669NH Respite - Other CategoryRespite Care - Other
0670OP Spec Residence/GeneralOutpatient Special Residence Charges - General Classification
0671OP spec Residence/Hosp BasedOutpatient Special Residence Charges - Hospital Owned
0672OP Spec Residence/ContractedOutpatient Special Residence Charges - Contracted
0679OP Spec Residence/OtherOutpatient Special Residence Charges - Other
0681Trauma Response - Level ITrauma Response - Level I
0682Trauma Response - Level IITrauma Response - Level II
0683Trauma Response - Level IIITrauma Response - Level III
0684Trauma Response - Level IVTrauma Response - Level IV
0689Trauma Response - OtherTrauma Response - Other
0690Pre-hospicePre-hospice/Palliative Care Services - General Classification
0691Pre-hospice/VisitPre-hospice/Palliative Care Services - Visit Charge
0692Pre-hospice/HourPre-hospice/Palliative Care Services - Hourly Charge
0693Pre-hospice/EvalPre-hospice/Palliative Care Services - Evaluation
0694Pre-hospice/Cons&EdPre-hospice/Palliative Care Services - Consultation and Education
0695Pre-hospice/IP Pre-hospice/Palliative Care Services - Inpatient Care
0696Pre-hospice/PhysicianPre-hospice/Palliative Care Services - Physician Services
0697ReservedReserved
0698ReservedReserved
0699Pre-hospice/OtherPre-hospice/Palliative Care Services - Other Pre-hospice/Palliative
0700Cast Room - GeneralCast Room - General Classification
0710Recovery Room - GeneralRecovery Room - General Classification
0720Labor Rm/Delivery - GeneralLabor Room/Delivery - General Classification
0721Labor Rm/Delivery - LaborLabor Room/Delivery - Labor
0722Labor Rm/Delivery - DeliveryLabor Room/Delivery - Delivery Room
0723Labor Rm/Delivery - CircumcisionLabor Room/Delivery - Circumcision
0724Labor Rm/Delivery - Birthing CenterLabor Room/Delivery - Birthing center
0729Labor Rm/Delivery - OtherLabor Room/Delivery - Other
0730EKG/ECG - GeneralEKG/ECG (Electrocardiogram) - General Classification
0731EKG/ECG - Holter MonitorEKG/ECG (Electrocardiogram) - Holter Monitor
0732EKG/ECG - TelemetryEKG/ECG (Electrocardiogram) - Telemetry
0739EKG/ECG - OtherEKG/ECG (Electrocardiogram) - Other
0740EEG - GeneralEEG (Electroencephalogram) - General Classification
0750GastroIntestinal Services - GeneralGastro-Intestinal (GI) Services - General Classification
0760Specialty Services - General ClassificationSpecialty Services - General Classification
0761Treatment RoomSpecialty Services - Treatment Room
0762Observation HoursSpecialty Services - Observation Hours
0769Other Specialty ServicesSpecialty Services - Other
0770Preventive Care Services - GeneralPreventive Care Services - General Classification
0771Preventive - Vaccine AdministrationPreventive Care Services - Vaccine Administration
0780Telemedicine - GeneralTelemedicine - General Classification
0790ESWT- GeneralExtra-Corporeal Shock Wave Therapy - General Classification
0800IP Renal Dialysis/GeneralInpatient Renal Dialysis - General Classification
0801IP HemodialysisInpatient Renal Dialysis - Hemodialysis
0802IP Peritoneal Dialysis (not CAPD)Inpatient Renal Dialysis - Peritoneal Dialysis (Non-CAPD)
0803IP Cont Periton Dialysis (CAPD)Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (CAPD)
0804IP Cont Cycle Perit Dialysis (CCPD)Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (CCPD)
0809IP Dialysis - OtherInpatient Renal Dialysis - Other
0810Organ Acq - GeneralAcquisition of Body Components - General Classification
0811Organ Acq - Living DonorAcquisition of Body Components - Living Donor
0812Organ Acq - Cadaver DonorAcquisition of Body Components - Cadaver Donor
0813Organ Acq - Unknown DonorAcquisition of Body Components - Unknown Donor
0814Unsuccessful SearchAcquisition of Body Components - Unsuccessful Organ Search - Donor Bank Charges
0815Stem CellAcquisition of Body Components - Stem Cells - Allogeneic (Effective 1/1/17)
0816ReservedReserved
0817ReservedReserved
0819Organ Acq - Other DonorAcquisition of Body Components - Other Donor
0820Hemo/OP or Home/General ClassificationHemodialysis - Outpatient or Home - General Classification
0821Hemo/OP or Home/Composite Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate
0822Hemo/OP or Home/Home/SupplHemodialysis - Outpatient or Home - Home Supplies
0823Hemo/OP or Home/Home/EquipHemodialysis - Outpatient or Home - Home Equipment
0824Hemo/OP or Home/Home/100%Hemodialysis - Outpatient or Home - Maintenance 100%
0825Hemo/OP or Home/Home/SupServHemodialysis - Outpatient or Home - Support Services
0826Hemo/OP or Home/AdditionalHemodialysis - Outpatient or Home - Hemodiialysis - Additional Hemodialysis Treatments With Medical Justification (Effective TBD)
0829Hemo/OP or Home/Other OPHemodialysis - Outpatient or Home - Other OP Hemodialysis
0830OP/H Peritoneal DialysisPeritoneal Dialysis - Outpatient or Home - General Classification
0831OP/H Peritoneal Dialysis - CompositePeritoneal Dialysis - Outpatient or Home - Peritoneal/Composite or Other Rate
0832Peritoneal Dialysis - Home SuppliesPeritoneal Dialysis - Outpatient or Home - Home Supplies
0833Peritoneal Dialysis - Home EquipmentPeritoneal Dialysis - Outpatient or Home - Home Equipment
0834OP/H Peritoneal Dialysis - Maintenance 100%Peritoneal Dialysis - Outpatient or Home - Maintenance 100%
0835OP/H Peritoneal Dialysis - Support ServicesPeritoneal Dialysis - Outpatient or Home - Support Services
0839OP/H Peritoneal Dialysis - OtherPeritoneal Dialysis - Outpatient or Home - Other
0840OP/H CAPD - GenContinuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - General Classification
0841OP/H CAPD - Composite/Othr RateContinuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate
0842OP/H CAPD Home SuppliesContinuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Supplies
0843CAPD OP-Home EquipmentContinuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Equipment
0844CAPD OP-Maintenance/100%Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Maintenance 100%
0845OP/H CCPD Support ServicesContinuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Support Services
0849CAPD/Home/OtherContinuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Other
0850CCPD/OP or HomeContinuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - General Classification
0851CCPD/CompositeContinuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate
0852OP/H CCPD - Home SuppliesContinuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Supplies
0853OP/H CCPD - Home EquipmentContinuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment
0854OP/H CCPD - Maintenance 100%Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Maintenance 100%
0855CCPD/Home/SuppServiceContinuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Support Services
0859CCPD/Home/OtherContinuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Other
0860Magnetoencephalography (MEG) Magnetoencephalography (MEG) - General Classification
0861Magnetoencephalography (MEG) Magnetoencephalography (MEG) - MEG
0870Cell/Gene Therapy - GeneralCell/Gene Therapy - General Classification
0871Cell/Gene Therapy - CollectionCell/Gene Therapy - Cell Collection
0872Cell/Gene Therapy - Processing/Storage Prior to TransportCell/Gene Therapy - Specialized Biologic Processing and Storage - Prior to Transport
0873Cell/Gene Therapy - Processing/Storage After ReceiptCell/Gene Therapy - Storage and Processing after receipt of cells from manufacturer
0874Cell/Gene Therapy - InfusionCell/Gene Therapy - Infusion of Modified Cells
0875Cell/Gene Therapy - InjectionCell/Gene Therapy - Injection of Modified Cells
0880Misc Dialysis - GeneralMiscellaneous Dialysis - General Classification
0881Dialysis - UltrafiltrationMiscellaneous Dialysis - Ultrafiltration
0882Home Dialysis Aid VisitMiscellaneous Dialysis - Home Dialysis Aid Visit
0889Misc Dialysis - OtherMiscellaneous Dialysis - Other
0890Pharmacy - Reserved (Use 0250 for General Classification)Pharmacy - Reserved (Use 0250 for General Classification)
0891Pharmacy - Special Processed DrugsPharmacy - Special Processed Drugs - FDA Approved Cell Therapy
0892Pharmacy - Special Processed Drugs Pharmacy - Special Processed Drugs - FDA Approved Gene Therapy
0893Pharmacy - Reserved (Extension of 025x and 063x)Pharmacy - Reserved (Extension of 025x and 063x)
0899Pharmacy - Reserved (Extension of 025x and 063x)Pharmacy - Reserved (Extension of 025x and 063x)
0900BH Tx - GeneralBehavior Health Treatments/Services - General Classification
0901BH - ElectroshockBehavior Health Treatments/Services - Electroshock Treatment
0902BH - Milieu TherapyBehavior Health Treatments/Services - Milieu Therapy
0903BH - Play TherapyBehavior Health Treatments/Services - Play Therapy
0904BH - Activity TherapyBehavior Health Treatments/Services - Activity Therapy
0905BH- Intnsv OP PsychBehavior Health Treatments/Services - Intensive Outpatient Services-Psychiatric
0906BH - Intnsv OP Chem DependBehavior Health Treatments/Services - Intensive Outpatient Services-Chemical Dependency
0907BH - Community Day TxBehavior Health Treatments/Services - Community Behavioral Health Program (Day Treatment)
0908BH - Reserve for Natl UseBH - Reserve for Natl Use
0909BH - Reserve for Natl UsePsychiatric/psychological treatments-other
0910BH _ Reserve for Natl UsePsychiatric/psychological services-general classification
0911BH - RehabBehavioral Health Treatment/Services - Rehabilitation
0912BH - PHBehavioral Health Treatment/Services - Partial Hospitalization - Less Intensive
0913BH - PH IntensiveBehavioral Health Treatment/Services - Partial Hospitalization - Intensive
0914BH - Individual RxBehavioral Health Treatment/Services - Individual Therapy
0915BH - Group RxBehavioral Health Treatment/Services - Group Therapy
0916BH - Family RxBehavioral Health Treatment/Services - Family Therapy
0917BH - Bio FeedbackBehavioral Health Treatment/Services - Bio Feedback
0918BH - TestingBehavioral Health Treatment/Services - Testing
0919BH - OtherBehavioral Health Treatment/Services - Other
0920Other Dx Services - GenOther Diagnostic Services - General Classification
0921Peripheral Vascular LabOther Diagnostic Services - Peripheral Vascular Lab
0922Electromyogram EMGOther Diagnostic Services - Electromyogram
0923Pap SmearOther Diagnostic Services - Pap Smear
0924Allergy TestOther Diagnostic Services - Allergy Test
0925Pregnancy TestOther Diagnostic Services - Pregnancy Test
0929Other Dx ServicesOther Diagnostic Services - Other Diagnostic Service
0931Med Rehab Day Prog - 1/2 DayMedical Rehabilitation Day Program - Half Day
0932Med Rehab Day Progr - Full DayMedical Rehabilitation Day Program - Full Day
0940Othr Therapeutic Srvc - GeneralOther Therapeutic Services - General Classification
0941Recreational TherapyOther Therapeutic Services - Recreational Therapy
0942Education/TrainingOther Therapeutic Services - Education/Training
0943Cardiac RehabOther Therapeutic Services - Cardiac Rehabilitation
0944Drug RehabOther Therapeutic Services - Drug Rehabilitation
0945Alcohol RehabOther Therapeutic Services - Alcohol Rehabilitation
0946Cmplx Med Equipm - RoutineOther Therapeutic Services - Complex Medical Equipment - Routine
0947Cmplx Med Equipm - AncillaryOther Therapeutic Services - Complex Medical Equipment - Ancillary
0948Pulmonary RehabilitationOther Therapeutic Services - Pulmonary Rehabilitation
0949Othr Therapeutic SrvcOther Therapeutic Services - Other
0951Athletic TrainingOther Therapeutic Services - Athletic Training
0952KinesiotherapyOther Therapeutic Services - Kinesiotherapy
0953Chemical Dependency (Drug and Alcohol)Chemical Dependency (Drug and Alcohol)
0960Pro Fees - GeneralProfessional Fees - General Classification
0961Pro Fee - PsychiatricProfessional Fees - Psychiatric
0962Pro Fees - OphthalmologyProfessional Fees - Ophthalmology
0963Pro Fees - Anesthesiologist (MD)Professional Fees - Anesthesiologist (MD)
0964Pro Fees - Anesthetist (CRNA)Professional Fees - Anesthetist (CRNA)
0969Pro Fees - OtherProfessional Fees - Other Professional Fees
0971Pro Fees - LabProfessional Fees - Laboratory
0972Pro Fees - Rad - DiagnosticProfessional Fees - Radiology - Diagnostic
0973Pro Fees - Rad - TherapeuticProfessional Fees - Radiology - Therapeutic
0974Pro Fee - Rad - Nuclear MedicineProfessional Fees - Radiology - Nuclear Medicine
0975Pro Fees - ORProfessional Fees - Operating Room
0976Pro Fees - Respiratory TherapyProfessional Fees - Respiratory Therapy
0977Pro Fees - PTProfessional Fees - Physical Therapy
0978Pro Fees - OTProfessional Fees - Occupational Therapy
0979Pro Fee - Speech Professional Fees - Speech Pathology
0981Pro Fees - ERProfessional Fees - Emergency Room
0982Pro Fees - OP ServicesProfessional Fees - Outpatient Services
0983Pro Fees - ClinicProfessional Fees - Clinic
0984Pro Fees - MSSProfessional Fees - Medical Social Services
0985Pro Fees - EKGProfessional Fees - EKG
0986Pro Fees - EEGProfessional Fees - EEG
0987Pro Fees - Hospital VisitProfessional Fees - Hospital Visit
0988Pro Fees - ConsultProfessional Fees - Consultation
0989Pro Fees - Private Duty NurseProfessional Fees - Private Duty Nurse
0990Pt Convenience - GeneralPatient Convenience Items - General Classification
0991Cafeteria/Guest TrayPatient Convenience Items - Cafeteria/Guest Tray
0992Private Linen ServicePatient Convenience Items - Private Linen Service
0993TelephonePatient Convenience Items - Telephone/Telecom
0994TV/RadioPatient Convenience Items - TV/Radio
0995Nonpt Room RentPatient Convenience Items - Non-patient Room Rentals
0996Late DischargePatient Convenience Items - Late Discharge
0997Admit KitPatient Convenience Items - Admission Kits
0998Barber/Beauty ShopPatient Convenience Items - Beauty Shop/Barber
0999Pt Convenience/OtherPatient Convenience Items - Other
1000BH - R&BBehavioral Health Accommodations - General Classification
1001BH - R&B Resid/PsychBehavioral Health Accommodations - Residential - Psychiatric
1002BH - R&B Resid/Chem Behavioral Health Accommodations - Residential - Chemical Dependency
1003BH - R&B/Sup LivingBehavioral Health Accommodations - Supervised Living
1004BH - R&B Halfway HouseBehavioral Health Accommodations - Halfway House
1005BH - R&B Group HomeBehavioral Health Accommodations - Group Home
1006BH - Outdoor/WildBehavioral Health Accomodations - Outdoor Wilderness Behavioral Health (Effective 7/1/17)
2101AcupunctureAlternative Therapy Services - Acupuncture
2102AccupressureAlternative Therapy Services - Acupressure
2103Massage TherapyAlternative Therapy Services - Massage
2104ReflexologyAlternative Therapy Services - Reflexology
2105BiofeedbackAlternative Therapy Services - Biofeedback
2106Hypnosis TherapyAlternative Therapy Services - Hypnosis
2109Other Alternative TherapyAlternative Therapy Services - Other
3101Adult Day Care - Med/Social - HrlyAdult Care - Adult Day Care, Medical and Social - Hourly
3102Adult Day Care - Social - HrlyAdult Care - Adult Day Care, Social - Hourly
3103Adult Day Care - Med/Social - DailyAdult Care - Adult Day Care, Medical and Social - Daily
3104Adult Day Care - Social - DailyAdult Care - Adult Day Care, Social - Daily
3105Adult Foster Care - DailyAdult Care - Adult Foster Care - Daily
3109Adult Care - OtherAdult Care - Other