Transcription of Medicare UB-04 Revenue Codes
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Medicare UB-04 Revenue Codes
Medicare UB-04 Revenue Codes Revised August 2010 National Government Services, Inc. For complete information regarding UB-04 coding please refer to the CMS IOM Publication 100-04, Chapter 25 1 294_0810 0001 Total Charge 002X HI Prosp Paymt System HIPPS 2 SNF PPS (RUG) 3 HH PPS (HRG) 4 IRF PPS (CMG) 0100 All-Inclusive Room & Board/Anc 1 All-Inclusive R&B 0110 Room/Board PVT 1 Medical/surgical/gyn 2 OB 3 Pediatric 4 Psychiatric 5 Hospice 6 Detoxification 7 Oncology 8 Rehabilitation 9 Other 0120 Room/Board SP 2 bd 1 Medical/surgical/gyn 2 OB 3 Pediatric 4 Psychiatric 5 Hospice 6 Detoxification 7 Oncology 8 Rehabilitation 9 Other 0130 Room/Board-SP 3-4 bd 1 Medical/surgical/gyn 2 OB 3 Pediatric 4 Psychia
9 Other peritoneal dialysis . 084X CAPD OPD/Home 1 CAPD/composite or other rate . 2 Home supplies . 3 Home equipment . 4 Maintenance/100% . Support services 9 Other CAPD dialysis 0850 CCPD - Outpatient 1 CCPD/composite or other rate . 4 Maintenance/100% 5 Support services Other CCPD dialysis 0880 Miscellaneous Dialysis 1 Ultra-filtration
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