The revenue code is a four-digit number used by doctors and other medical care providers to report services and procedures to insurance companies and Medicare for the purpose of reimbursement. It is made up of two parts: the first two digits represent the type of service or procedure, while the last two digits provide a more specific description of what specific type of service was provided.
The American Medical Association and the Centers for Medicare & Medicaid Services assign the first two digits and publish the results in the HCPCS (Healthcare Common Procedure Coding System) annual manual. The last two digits are supplied by the doctor or provider who performed the service.
Revenue codes are used to classify the types of services provided, allowing the insurance provider (or government program) to accurately determine the amount of reimbursement. For example, code 0184 is used to describe an office visit, while code 99140 is used to describe an urgent care visit.
It is important to note that the revenue code is NOT the same as the CPT (Current Procedural Terminology) code. The CPT code is five digits and is used to describe a procedure for all entities, such as insurance companies and medical practitioners.
If you are confused about a particular revenue code, you should contact your healthcare provider or the insurance company to clarify any ambiguities. You can learn more about revenue codes by visiting the Centers for Medicare & Medicaid Services website or the American Medical Association's website.