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September 2013

Healthcare Common Procedure Coding System codes updated for revenue code chart

Blue Cross Blue Shield of Michigan has made some changes to a table listing revenue codes and a description of the service categories they represent.

We’re providing the updated chart below for your reference. The revenue codes and HCPCS requirements listed below are effective Oct. 1, 2013.

The original table appeared in the article titled, "Hospital outpatient reimbursement, HCPCS payment rules, revenue code information summarized," in the January 2013 Record.

Changes to the table include:

  • Revenue code 0255 was deleted from the “drug and pharmacy” (IVT-chemo) category, and revenue code 0750 was added to the “other” category.
  • Revenue codes marked with a single asterisk won’t always have CPT or HCPCS codes that can be reported with them. For example, there are no CPT or HCPCS codes available for certain medical supplies. Just use the appropriate revenue code for the medical supplies dispensed. 

Description

Revenue codes that require HCPCS codes

Surgery (including maternity)

 0360, 0361, 0369, 0490, 0499, 0700, 0750, 0769, 0790

Codes that require a surgical HCPCS code if surgery is performed in this room:  0450, 0451, 0452, 0456, 0510, 0511, 0512, 0513, 0514, 0515, 0516, 0519,  0761

Laboratory – clinical or anatomical

0300, 0301, 0302, 0303, 0304, 0305, 0306, 0307, 0309, 0310, 0311, 0312, 0314, 0319, 0923, 0924, 0925

Other

0270*, 0271*, 0272*, 0279*, 0280, 0289, 0370, 0379, 0380, 0381, 0382, 0383, 0384, 0385, 0386, 0387, 0389, 0390, 0391, 0392, 0399, 0410, 0412, 0413, 0419, 0450, 0451, 0452, 0456, 0459, 0460, 0469, 0470, 0471, 0472, 0479, 0480, 0481, 0482, 0483, 0489, 0500, 0509, 0510, 0511, 0512, 0514, 0515, 0516, 0517, 0519, 0530, 0531, 0539, 0540, 0545, 0621, 0622, 0623, 0730**, 0731, 0732, 0739, 0740, 0750, 0780, 0920, 0921, 0922, 0929, 0940, 0942, 0943, 0949, 0951, 0952, 2101, 2105, 2106

Durable medical equipment/prosthetic & orthotic devices

0274, 0291, 0292, 0293, 0946, 0947

Drug administration

0260, 0331, 0332, 0335, 0771

Drug and pharmacy

0250*, 0251, 0252, 0253, 0254, 0256, 0257, 0258, 0259, 0262, 0631, 0632, 0633, 0634, 0635, 0636, 0637

Radiopharmaceutical

0255, 0343, 0349

Radiology

0255, 0320, 0321, 0322, 0323, 0324, 0329, 0330, 0333, 0339, 0340, 0341, 0342, 0343, 0344, 0349, 0350, 0351, 0352, 0359, 0400, 0401, 0402, 0403, 0404, 0409, 0610, 0611, 0612, 0614, 0615, 0616, 0618, 0619, 0860, 0861

Emergency room and  trauma

0450, 0451, 0452, 0459, 0681, 0682, 0683, 0684, 0689

Surgery (maternity)

Refer to "Surgery"

Treatment room

0761

Observation room

0762

Physical therapy, occupational therapy, speech and language pathology evaluation

0424, 0434, 0444

Physical therapy, occupational therapy, speech and language pathology visit

0421, 0431, 0441

** Ambulatory surgery facilities must report the applicable EKG CPT or HCPCS code when reporting revenue code 0730. Other applicable revenue codes and CPT or HCPCS code information for laboratory, radiology and surgery services are included above.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2012 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
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