Description:
A revenue code is a code which identifies a specific accommodation, ancillary service, or billing calculation on a UB-04 claim form.  Many of these codes are structured so that the initial code identifies the service performed, but describes the service as general (i.e. Revenue Code 420 – Physical Therapy – General).

Policy Statement:
Any service filed under a covered revenue code will pay whether the service is a covered benefit or a non-covered benefit.  Services will deny only if the revenue code is a non-covered service (i.e Revenue Code 990 – Patient Convenience Items – General).

If a provider should file a non-covered service under a covered revenue code, this will not be recorded as a payment error.  These claims will be handled on a post-payment review basis, with the necessary refund requests and provider education.

NOTE:  This policy refers to local accounts only.  It is not applicable to National Accounts