1 Emergency
2 Urgent
3 Elective
4 Newborn
5 Trauma Center
9 Information Not Available
Payer Codes No. Payer Code Description
1 Medicaid
2 Blue Cross
3 Other
4 None
A Working Aged (Value Code 12)
B ESRD beneficiary in 30 month coordination period with EGHP (Value Code 13)
C Conditional Payment
D Auto no-fault (Value Code 14)
E Workers Comp (Value Code 15)
F Public Health or Federal Agency (Value Code 16)
G Disabled (Value Code 43)
H Black Lung (Value Code 41)
I Veterans Administration (Value Code 42)
L Liability (Value Code 47)
Z Medicare
Note: Payer codes 1 through 4 are used when the other payer is secondary. The alpha payer codes are used
when the other payer is primary
Repetitive Services
Services repeated over a span of time and billed with the following revenue codes are defined as repetitive
services. Repetitive services are required to be billed monthly or at the end of treatment. Any items and/or
services in support of the repetitive service should be reported on the same claim (example: disposable supplies,
drugs or equipment used to furnish the repetitive service).
Type of Service Revenue Code
DME Rental 0290 - 0299
Respiratory Therapy 0410, 0412, 0419
Physical Therapy 0420 - 0429
Occupational Therapy 0430 - 0439
Speech-Language Pathology 0440 - 0449
Skilled Nursing 0550 – 0559
Kidney Dialysis Treatments 0820 - 0859
Cardiac Rehab Services 0482, 0943
Pulmonary Rehabilitation Services 948
Note: Report occurrence span code 74 on the monthly repetitive service bill to encompass any inpatient stay
dates, day of outpatient surgery, or outpatient hospital services subject to OPPS.
Note: If a non-repetitive OPPS service is provided on the same date of a repetitive service, report the nonrepetitive
OPPS service (along with any packaged and/or services related to the non-repetitive service) on a
separate OPPS claim.
No comments:
Post a Comment