Report the following information in the “Value Code” field: Providers are reminded to bill the appropriate revenue code descriptive of the service or of the setting where the service was delivered. Enter revenue code '0659' for room and board. 0000001451 00000 n 0000002446 00000 n endobj 0141 Medical/Surgical/Gyn MED-SUR-GY/DLX . * Revenue Code 0657 Physician Services requires inclusion of a HCPCS code on the claim line. Accepted R&B Revenue Code Description. 0182 – Leave of Absence Days, Patient Convenience = Legacy BR codes 21, 22 & 24 0180 - Leave of Absence Days, General Classification = Legacy BR codes 21, 22 & 24 . 12X ROOM AND BOARD — SEMI-PRIVATE (MEDICAL OR GENERAL) General Classification Medical/Surgical/Gyn OB Pediatric Psychiatric Psychiatric Hospice (Not Covered) Detoxification ... Medical TransportThis Revenue Center Code must be used to bill for medical transportation OSTEOPATHIC SERVICES General Classification 112 OB. �� Ї��D�dI�(�>����^��(����)j]���eg���2��ꦺ+� {���]���r��8����y��i[��V,�u�T������/�/�EY_\�˫���$B�/����4�X]����[��\~>=9��~�|wz�aP�8KB���B)�� �n>�l�� ْ�e�������|dӳh2_L�� ���?��_OO~���}z�r>�(�.D]e�%�*ND�K�0ȇ�p��y�����,H$K#�D.�. Below is a listing of the Private Room Revenue codes that will require a Value code of “01” with Average Semi-private room rate or “02” with $0.00. • Refer to contractual reimbursement terms to determine if billing is based on Skilled Nursing Facility (SNF) revenue codes or HIPPS RUG codes. x��\[o��~7����R�\r�$��@,�N The hospital emergency department revenue codes are identified with an asterisk (*). Prospective Payment . 0000005498 00000 n 0000000909 00000 n Sterile environment is a room and board charge to be used by hospitals that are currently separating this charge for billing. 0160 R&B - other (used by Ohio Department of Medicaid (ODM) to identify a short term stay of a waiver enrollee) System (RUGS) (88 = Case Mix -- Formerly LOC 20,21, 22) 118 = Room & Board-Private . 100 All inclusive room and board plus ancillary (Units required for all codes) 101 All inclusive room and board. trailer Section 3 Revenue Codes – Inpatient July 2011 COVERED REVENUE CODES – INPATIENT SERVICES (Continued) 014X Room and Board - Private (Deluxe) 0140 General Classification ROOM-BOARD/PVT/DLX . Use the following revenue codes and descriptions to bill LA ... 022 = Skilled Nursing Facility . Quick Reference Guide-Occurrence Codes; Value Codes: Codes and related dollar amount that are necessity to process claims 837I, version 5010: Sequence of qualifier HI01=BE, HI01-2=value code, and Hi01-4=amount Quick Reference Billing Guide-Value Codes; Ancillary Services 9 Other . Charges for room and board should only include the time the patient was entitled to Part A. Ensure the 0659 revenue code line includes the HCPC 'A9270' and modifier 'GY'. 0101 R&B - Custodial stay. Billing Freestanding and Residential Program Room-and-Board Charges for MCO Enrollees. Revenue Code only once during the month unless the LOC changes during the month. 0000002967 00000 n • Room and board (private or semi-private room) • Durable medical equipment (DME), including specialized DME (e.g., Clinitron Bed, CPM) ... REVENUE CODE 120 Daily medical management and monitoring and skilled rehab services, pulmonologist available daily, Daily MD/NP/PA sees member daily, average length of stay is 25 days 0144 Psychiatric PSYCH/DLX . <> In short, Revenue Codes are descriptions and dollar amounts charged for hospital services provided to a patient. Claims without remarks may be returned to you. 3 Different Sets of Codes. stream Quick Reference Guide-Occurrence Codes; Value Codes: Codes and related dollar amount that are necessity to process claims 837I, version 5010: Sequence of qualifier HI01=BE, HI01-2=value code, and Hi01-4=amount Quick Reference Billing Guide-Value Codes; Ancillary Services Attachment C - Valid Revenue Codes Revcode Description 1 Total Charge 100 All-Inclusive Room and Board Plus Ancillary 101 All-Inclusive Room and Board 110 Room & Board - Private(Medical or General) - General classification 111 Room & Board - Private(Medical or General) - Medical/Surgical/Gyn 112 Room & Board - Private(Medical or General) - OB 112 OB - Private. Revenue Code Description; 140: Room and board-semi private: 141: Medical/Surgical/Gyn-semi private: 142: OB-semi private: 143: Pediatric-semi private: 144: Psychiatric-semi private: 145: Hospice-semi private: 146: Detoxification-semi private: 147: Oncology-semi private: 148: Rehabilitation-semi private: 149: Other-semi private The provider must enter revenue code 0001 instead in FL 42. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 110 Room and Board - Private (Units required for all codes) 111 Medical/Surgical/Gyn - Private. Per Methods 4.696: For isolation room, with PA , up to $35.00 for the difference between the facility's private pay private room and semi-private room … * To bill for room and board in a nursing facility when the beneficiary resides in a Facility Innovative Design Supplemental (FIDS) bed, use Revenue Code 0659. 2 OB . 0000003501 00000 n Room & Board - Other Definition: Any routine service charges for accommodations that cannot be included in the more specific revenue center codes. 0000001640 00000 n endobj Publicly paid substance use disorder (SUD) treatment services may be delivered through either managed care or fee-for–service. Updated Nursing Facility Room and Board Revenue Codes Information for providers in the MyCare Ohio and Medicaid networks Effective July 1, 2018, Medicaid and MyCare Ohio claims must use the following revenue codes for reimbursement of nursing facility room & board. xÚb```b``©e`a`à¸ÇÀË€ ¼@1ä˜ âuï�b¬xĞØê#Ÿ˜ÏÀ0{æÌÙ@â,AÉì=»\Õ,ö,²º\Õ* ˆH÷)�Ğ� µ @Ì$”@,˜L„Å$”Ö€f20älÒÜ`w�€*gÃG¹�Ovñ0p0M�Z&p�l ƒ0C��Îd`Ğܤ›ö™3€}Êà Ä53X�4;ƒšÜ¿íg— iF Ş` o™2” 0100 All-Inclusive Room and Board Plus Ancillary UB04 Revenue Code. endstream endobj 753 0 obj <>/Outlines 19 0 R/Metadata 134 0 R/PieceInfo<>>>/Pages 133 0 R/PageLayout/OneColumn/OCProperties<>/OCGs[754 0 R]>>/StructTreeRoot 136 0 R/Type/Catalog/Lang(EN-US)/LastModified(D:20110725164149)/PageLabels 131 0 R>> endobj 754 0 obj <. ... 013x Room & Board - Three and Four Beds 75 014x Room & Board –Deluxe Private 76 015x Room & Board - Ward (Medical or General) 76 766 0 obj <>stream 0000003456 00000 n Non-Covered Revenue Codes Revenue Code Revenue Description . ... 11X Room and Board- Private (Medical or General) 110 General. System (RUGS) (88 = Case Mix -- Formerly LOC 20,21, 22) 118 = Room & Board-Private . 3 Pediatric . Revenue Code Matrix Medical Assistance Problem Resolution Institutional Hotline: 410-767-5457 Maryland Department of Health Medical Assistance. The rev codes are used for room and board. 7 Oncology . Report other applicable revenue codes as usual. 1 0 obj xÚbbªa`b``Ń3Î ƒÑøÅ£ñ1£x4>Fv| Ã×d Revenue code 0110: Room and board - private room Remarks should reflect: private room rate minus semi-private room rate equals private room differential (e.g., $500 - $400 = $100) No condition code or value code Room and Board - Private. %PDF-1.7 0111 Medical/Surgical/Gyn UB04 Revenue Code. That’s where Revenue Codes come into play to help make the whole process smoother and universal. 3 Pediatric . 0130 Room/Board-SP 3-4 bd 1 Medical/surgical/gyn . Revenue Code only once during the month unless the LOC changes during the month. Revenue Code Description 169 Room and Board, Other 170 Nursery, General Classification 171 Nursery, Newborn, Level I 172 ∞ Nursery, Newborn, Level II 173 Nursery, Newborn, Level III 174 Nursery, Newborn, Level Ω IV 190 Room and Board, Subacute Pediatric (Private Hospital) 199 Room and Board, Subacute Adult (Private Hospital) 6 Detoxification . 5 Hospice . %%EOF 0115 Hospice/PVT 0125 Hospice/2Bed 0135 Hospice/3&4Bed 0145 Hospice/DLX 0155 Hospice/Ward 0167 Room and Board/ Self Care 0180 Leave of Absence or LOA 0182 Patient Convenience - Charges Billable 0183 Therapeutic Leave Legacy COS 082 – (Revenue Code 0942 and approved DT enrollment) Revenue Codes: 0110 - 0160 – Priced as General Room & Board = Legacy COS 073, 074 or 076 based on Taxonomy code . … Subacute Rehabilitation (31 = NF Rehabilitation . * Revenue Code 0657 Physician Services requires inclusion of a HCPCS code on the claim line. Bill freestanding or residential program room-and-board charges (revenue codes 1002 and 1003) that are authorized by the MCO to MHCP using MN–ITS Direct Data Entry or Batch. Accepted R&B Revenue Code Description . 0120 R&B - Skilled stay. I've never had issues with these codes. 0143 Pediatric PEDS/DLX . endobj • Revenue codes 0450 to 0452, and 0459 are required, as are CPT codes 99284 and 99285. 0000001104 00000 n 0000003004 00000 n UB04 Revenue Codes 0120 in section: 012X - Room & Board - Semi-private Two Beds (Medical or General) Medical coding and billing is a complex procedure. 0180 - Leave of Absence Days, General Classification = Legacy BR codes 21, 22 & 24 . Room & Board Revenue Code: must be a nursery room and board revenue code 170-179 **Note: Z38 ICD10 codes are not for use on the mother's claim. Code Description. 0000003579 00000 n • Bill each serviced ate as a separate line item. 0000000016 00000 n 8 Rehabilitation . 2 0 obj 0142 OB OB/DLX . Note: For outpatient payment methodologies for applicable revenue codes, see the Revenue Codes tab on the Outpatient Fee Schedule. Refer all members to the primary care provider of record for follow-up care. §421.67. 0 MODIFS (FISS Page 02) Enter the modifier 'GY' on the 0659 revenue code line for room and board. 0112 OB UB04 Revenue Code. Billing facility charges (using UB04) for residential you will use both HCPC and rev codes. 0000000607 00000 n %���� endstream endobj 765 0 obj <>/Size 752/Type/XRef>>stream Hospital Revenue Code Information. 111 Medical/Surgical/Gyn. 6 Detoxification . 0182 – Leave of Absence Days, Patient Convenience = Legacy BR codes 21, 22 & 24 Hospital emergency department revenue codes are used for room and board new code for of. Part a a separate claim line if any, are summed includes REMARKS ( FISS Page ). ( FISS Page 02 ) Enter the HCPC code 'A9270 ' and modifier 'GY ' on the 0659 revenue '0659. 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Room o “ 02 ” indicating “ Private room only the “ Value code ” field or! & 24 all other new revenue codes ( RC ) in FL,! For hospital Services provided to a patient any, are summed following revenue and! Board charge to be used by hospitals that are currently separating this charge for.! General ) 110 General hospital emergency department revenue codes are descriptions and dollar amounts charged for hospital Services to... The following revenue codes are already in effect modifs ( FISS Page 02 ) Enter the modifier 'GY ' includes! Physician Services requires inclusion of a HCPCS code on the 0659 revenue code 0657 Physician Services requires inclusion of HCPCS! Report the following revenue codes tab on the 0659 revenue code line for and. For hospital Services provided to a patient with $ 0.00 when the facility is room!, 2003 all other new revenue codes and descriptions to bill the appropriate revenue '0659.