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Revenue Code and HCPCS Code Requirements


Provider Administrative Policy

Section
Hospital
Policy Date
July 2011
Status/Date
Revised/June 2012
Provider Type(s)
Hospitals  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Revenue Code and HCPCS Code Requirements

Effective for claims submitted on a UB-04 form or 837i transaction and processed after July 4, 2011, all revenue codes require HCPCS codes on commercial outpatient claims EXCEPT the following:

0250 0251 0252 0253 0257 0258 0259 0260 0261 0262
0263 0264 0269 0270 0271 0272 0273 0276 0279 0280
0289 0343 0344 0370 0371 0372 0379 0390 0392 0399
0500 0509 0521 0522 0524 0525 0527 0528 0560 0569
0583 0621 0622 0623 0624 0630 0631 0632 0633 0637
0660 0661 0662 0663 0669 0681 0682 0683 0684 0689
0700 0710 0720 0721 0732 0762 0801 0802 0803 0804
0809 0810 0819 0821 0824 0825 0829 0860 0861 0905
0906 0907 0931 0932 0942* 0943 0948 0990 0991 0992
0993 0994 0995 0996 0997 0998 0999 1000 1001 1002
1003 1004 1005 2100 2101 2102 2103 2104 2105 2106
2109 3101 3102 3103 3104 3105  3109      

 *HCPCS codes are required on revenue code 0942 for charges associated with diabetes education servics.

Please make sure you are applying HCPCS codes to line items with all other revenue codes. If a HCPCS code is missing on a revenue code that requires one, that line item will be denied on your claim.


Policy History

Date Action Reason
June 2012 Revised Added language for revenue code 0942
July 2011 New Pollicy New Policy
August 2011 Revised Added code 0253

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