SECTION 3 REVENUE CODES - INPATIENT
Section 3
Revenue Codes ? Inpatient
July 2011
SECTION 3 REVENUE CODES - INPATIENT
COVERED REVENUE CODES ? INPATIENT SERVICES
A. ACCOMMODATIONS
Code Description
Abbreviation
010X All Inclusive Rate 0101 All-Inclusive Room and Board
ALL INCL R&B
011X Room and Board - Private (Medical or General)
0110 General Classification
ROOM-BOARD/PVT
0111 Medical/Surgical/Gyn
MED-SUR-GY/PVT
0112 Obstetric
OB/PVT
0113 Pediatric
PEDS/PVT
0114 Psychiatric
PSYCH/PVT
0116 Detoxification
DETOX/PVT
0117 Oncology
ONCOLOGY/PVT
0118 Rehabilitation
REHAB/PVT
0119 Other
OTHER/PVT
012X Room and Board - Semi-Private Two Bed (Medical or General)
0120 General Classification
ROOM-BOARD/SEMI
0121 Medical/Surgical/Gyn
MED-SUR-GYN/2BED
0122 OB
OB/2BED
0123 Pediatric
PEDS/2BED
0124 Psychiatric
PSTAY/2BED
0126 Detoxification
DETOX/2BED
0127 Oncology
ONCOLOGY/2BED
0128 Rehabilitation
REHAB/2BED
0129 Other
OTHER/2BED
013X Room and Board - Semi-Private - Three and Four Beds
0130 General Classification
ROOM-BOARD/3&4BED
0131 Medical/Surgical/Gyn
MED-SUR-GY/3&4BED
0132 OB
OB/3&4BED
0133 Pediatric
PEDS/3&4BED
0134 Psychiatric
PSYCH/3&4BED
0136 Detoxification
DETOX/3&4BED
0137 Oncology
ONCOLOGY/3&4BED
0138 Rehabilitation
REHAB/3&4BED
0139 Other
OTHER/3&4BED
3.1
Section 3
Revenue Codes ? Inpatient
July 2011
COVERED REVENUE CODES ? INPATIENT SERVICES (Continued)
014X Room and Board - Private (Deluxe) 0140 General Classification 0141 Medical/Surgical/Gyn 0142 OB 0143 Pediatric 0144 Psychiatric 0146 Detoxification 0147 Oncology 0148 Rehabilitation 0149 Other
ROOM-BOARD/PVT/DLX MED-SUR-GY/DLX OB/DLX PEDS/DLX PSYCH/DLX DETOX/DLX ONCOLOGY/DLX REHAB/DLX OTHER/DLX
015X Room and Board ? Ward (Medical or General)
0150 General Classification
ROOM-BOARD/WARD
0151 Medical/Surgical/Gyn
MED-SUR-GY/WARD
0152 OB
OB/WARD
0153 Pediatric
PEDS/WARD
0154 Psychiatric
PSYCH/ WARD
0156 Detoxification
DETOX/WARD
0157 Oncology
ONCOLOGY/WARD
0158 Rehabilitation
REHAB/WARD
0159 Other
OTHER/WARD
016X Room and Board - Other 0164 Sterile Environment
R&B/STERILE
017X Nursery 0170 General Classification 0171 Newborn - Level I 0172 Newborn - Level II 0173 Newborn - Level III 0174 Newborn - Level IV 0179 Other Nursery
NURSERY NURSERY/LEVELI NURSERY/LEVELII NURSERY/LEVELIII NURSERY/LEVELIV NURSERY/OTHER
020X Intensive Care 0200 General Classification 0201 Surgical 0202 Medical 0203 Pediatric Intensive Care 0204 Psychiatric 0206 Intermediate ICU 0207 Burn Care 0208 Trauma 0209 Other Intensive Care
INTENSIVE CARE (or ICU) ICU/SURGICAL ICU/MEDICAL ICU/PEDS ICU/PSTAY ICU/INTERMEDIATE ICU/BURN CARE ICU/TRAMA ICU/OTHER
3.2
Section 3
Revenue Codes ? Inpatient
July 2011
COVERED REVENUE CODES ? INPATIENT SERVICES (Continued)
021X Coronary Care 0210 General Classification 0211 Myocardial Infarction 0212 Pulmonary Care 0214 Intermediate CCU 0219 Other Coronary Care
CORONOARY CARE (or CCU) CCU/MYO INFARC CCU/PULMONARY CCU/INTERMEDIATE CCU/OTHER
B. ANCILLARIES
Code Description
Abbreviation
025X Pharmacy 0250 General Classification 0251 Generic Drugs 0252 Non-generic Drugs 0254 Drugs Incident to Other
Diagnostic Services 0255 Drugs Incident to Radiology 0257 Non-prescription Drugs 0258 IV Solutions 0259 Other Pharmacy
PHARMACY DRUGS/GENERIC DRUGS/NONGENERIC
DRUGS/INCIDENT/ODX DRUGS/ INCIDENT RAD DRUGS/NONPSCRPT IV SOLUTIONS DRUGS/OTHER
026X I.V. Therapy 0260 General Classification 0261 Infusion Pump 0262 IV Therapy/Pharmacy Svcs 0263 IV Therapy/Drug/Supply Delivery 0264 IV Therapy/Supplies 0269 Other IV Therapy
IV THERAPY IV THER/INFSN PUMP IV THER/PHARM/SVC IV THER/DRUG/SUPPLY DELV IV THER/SUPPLIES IV THER/OTHER
027X Medical/Surgical Supplies and Devices
0270 General Classification
MED-SUR SUPPLIES
0271 Non-Sterile Supply
NON-STER SUPPLY
0272 Sterile Supply
STERILE SUPPLY
0275 Pacemaker
PACE MAKER
0276 Intraocular Lens
INTRA OC LENS
0278 Other Implant
SUPPLY/IMPLANTS
0279 Other Supplies/Devices
SUPPLY/OTHER
028X Oncology 0280 General Classification 0289 Other Oncology
ONCOLOGY ONCOLOGY/OTHER
3.3
Section 3
Revenue Codes ? Inpatient
July 2011
COVERED REVENUE CODES ? INPATIENT SERVICES (Continued)
030X Laboratory 0300 General Classification 0301 Chemistry 0302 Immunology 0304 Non-routine Dialysis 0305 Hematology 0306 Bacteriology & Microbiology 0307 Urology 0309 Other Laboratory
LABORATORY or (LAB) LAB/CHEMISTRY LAB/IMMUNOLOGY LAB/NR DIALYSIS LAB/HEMATOLOGY LAB/BACT-MICRO LAB/UROLOGY LAB/OTHER
031X Laboratory Pathological 0310 General Classification 0311 Cytology 0312 Histology 0314 Biopsy 0319 Other Laboratory Pathological
PATHOLOGY LAB (PATH LAB) PATHOL/CYTOLOGY PATHOL/HISTOL PATHOL/BIOPSY PATHOL/OTHER
032X Radiology - Diagnostic 0320 General Classification 0321 Angiocardiography 0322 Arthrography 0323 Arteriography 0324 Chest X-ray 0329 Other Radiology - Diagnostic
DX X-RAY DX X-RAY/ANGIO DX X-RAY/ARTH DX X-RAY/ARTER DX X-RAY/CHEST DX X-RAY/OTHER
033x Radiology ? Therapeutic and/or Chemotherapy Administration
0330 General Classification
RX X-RAY
0331 Chemotherapy Administration-Injected CHEMOTHER/INJ
0332 Chemotherapy Administration-Oral
CHEMOTHER/ORAL
0333 Radiation Therapy
RADIATION RX
0335 Chemotherapy Administration - IV
CHEMOTHERP-IV
0339 Other Radiology - Therapeutic
RX X-RAY/OTHER
034X Nuclear Medicine 0340 General Classification 0341 Diagnostic Procedures 0342 Therapeutic Procedures 0343 Diagnostic
Radiopharmaceuticals 0344 Therapeutic
Radiopharmaceuticals 0349 Other
NUCLEAR MEDICINE or (NUC MED) NUC MED/DX NUC MED/RX
NUC MED/DX RADIOPHARM
NUC MED/RX RADIOPHARM NUC MED/OTHER
3.4
Section 3
Revenue Codes ? Inpatient
July 2011
COVERED REVENUE CODES ? INPATIENT SERVICES (Continued)
035X CT Scan 0350 General Classification 0351 Head Scan 0352 Body Scan 0359 Other CT Scan
CT Scan CT SCAN/HEAD CT SCAN/BODY CT SCAN/OTHER
036X Operating Room Service 0360 General Classification 0361 Minor Surgery 0369 Other Operating Room Services
OR SERVICES OR/MINOR OR/OTHER
037X Anesthesia 0370 General Classification 0371 Anesthesia Incident to Radiology 0372 Anesthesia Incident to
Other Diagnostic Services 0379 Other Anesthesia
ANESTHESIA ANESTHE/INCIDENT RAD
ANESTH/INCIDENT OTHER DX ANESTHESIA/OTHER
038X Blood 0380 General Classification 0381 Packed Red Cells 0382 Whole Blood 0383 Plasma 0384 Platelets 0385 Leucocytes 0386 Other Components 0387 Other Derivatives (Cryopricipitates) 0389 Other Blood
BLOOD BLOOD/PKD RED BLOOD/WHOLE BLOOD/PLASMA BLOOD/PLATELETS BLOOD/LEUCOCYTES BLOOD/COMPONENTS BLOOD/DERIVATIVES BLOOD/OTHER
039X Blood and Blood Component Administration, Processing and Storage
0390 General Classification
BLOOD/STOR-PROC
0391 Administration (e.g. Transfusion)
BLOOD/ADMIN
0399 Other Processing and Storage
BLOOD/OTHER STOR
040X Other Imaging Services 0400 General Classification 0401 Diagnostic Mammography 0402 Ultrasound 0403 Screening Mammography 0404 Positron Emission Tomography 0409 Other Imaging Services
IMAGE SERVICE DIAG MAMMOGRAPHY ULTRASOUND SCRN MAMMOGRAPHY PET SCAN OTHER IMAG SVS
3.5
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