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FISS/DDE Provider Online Guide: Chapter IV


Revenue Codes (13)

Purpose

The purpose of the REVENUE CODES option is to provide access to details related to the revenue codes available to be reported on a claim.

A revenue code is a four-digit number that identifies where the patient was when they received treatment, and what type of item/service a patient received.

Note: All revenue codes listed in the REVENUE CODES option match the FISS editing files. Claims submitted that do not correspond with the data contained within the revenue code option will be RTP.

FISS Inquiry Submenu

To access the REVENUE CODES option from the FISS online system INQUIRES submenu, type ‘13’ at the Enter Menu Selection: prompt, then press <Enter>.

Upon selecting the REVENUE CODES option, the initial REVENUE CODE TABLE INQUIRY screen is available:

FISS Inquiry Menu - FISS Inquiry Menu - Enter option 13 to access the Revenue Codes section

To access revenue code data, type the four-digit revenue code you wish to research in the REV CD field, then press <Enter>.  

The Revenue Code Table Inquiry screen is updated to provide the revenue code details. As an example, the results of an inquiry for revenue code 0320 is shown:

Revenue Code screen example - This page shows an example of revenue code 0320 and the associated claim elements that are required

REV CD

Revenue code– Identifies the location/type of service that is being billed for Medicare reimbursement (four-position alphanumeric field)
Valid values
0001–9999

EFF DT

Effective date– Identifies the date this revenue code became effective (six-position alphanumeric field in MMDDYY format)

IND

Effective date indicator– The effective indicator instructs the system to either use the FROM date on the claim or to use the system run date to perform edits for this particular revenue code (one-position alphanumeric field)

Valid values
F = Claim from date
R
= Claim receipt date
D = Claim discharge date

TERM DT

Termination date– Identifies the date this revenue code became invalid (six-position alphanumeric field in MMDDYY format)

NARR

Narrative– Identifies the description or narrative for the revenue code (70-position alphanumeric field)

TOB

Type of bill– Identifies the type of facility, bill classification, and frequency of the claim in a particular period of care (three-position alphanumeric field)

ALLOW: EFF-DT TRM-DT

Allowable– Identifies whether or not this revenue code is currently valid (one-position alphanumeric field)

Valid values
Y
= Yes
N = No
If Y is indicated, the revenue code is allowable for the bill type. Effective date is indicated if a Y is present, as well as a termination date, if applicable.

HCPCS: EFF-DT TRM-DT

HCPCS Code – Indicates whether the revenue code requires a HCPCS code.

Valid values
Y =
Required
N =
Not required
V =
Verify valid HCPCS code
If Y is indicated, then effective date is indicated as well as a termination date, if applicable.
If V is indicated, then the system will verify that the HCPCS entered on the claim is a valid HCPCS per the HCPCS file, but will not require a HCPCS to be entered in order to process the claim.

UNITS: EFF-DT TRM-DT

Units – Indicates whether units are required for the bill type.

Valid values
Y =
Required
N =
Not required
If Y, then effective date is indicated as well as a termination date, if applicable.

RATE: EFF-DT TRM-DT

Rate – Indicates whether the revenue code requires a rate to be billed.

Valid values
Y =
Required
N =
Not required
If Y, then effective date is indicated as well as a termination date, if applicable.

Additional bill types can be accessed by using the <PF/F6> key to scroll forward.

Please note: NUBC maintains the revenue code tables. Contact the NUBC for a subscription.

[Return to FISS/DDE Provider Online Guide Index]
FISS/DDE Provider Online Guide: Chapter IV - Revenue Codes (13)
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