Revenue
Code Description
Category
0001 Total Charge
0100 All-Inclusive Room and Board Plus All Inclusive Rate
0110 General Classification ROOM-BOARD/PVT Room & Board - Private
0111 Medical/Surgical/GYN MED-SUR-GY/PVT Room & Board - Private
0112 OB OB/PVT Room & Board - Private
0113 Pediatric PEDS/PVT Room & Board - Private
0114 Psychiatric PSYCH/PVT Room & Board - Private
0116 Detoxification DETOX/PVT Room & Board - Private
0117 Oncology ONCOLOGY/PVT Room & Board - Private
0118 Rehabilitation REHAB/PVT Room & Board - Private
0119 Other OTHER/PVT Room & Board - Private
0120 General Classification ROOM-BOARD/SEMI
Room & Board - Semi-private Two Bed
0121 Medical/Surgical/GYNMED-SUR-GY/2BED Room & Board - Semi-private Two Bed
0122 OB - OB/2BED
Room & Board - Semi-private Two Bed
0123 Pediatric - PEDS/2BED Room & Board - Semi-private Two Bed
0124 Psychiatric - PSTAY/2BED
Room & Board - Semi-private Two Bed
0136 Detoxification - DETOX/3&4BED
Room & Board - Semi-Private - Three and Four Beds
0137 Oncology - ONCOLOGY/3&4BED
Room & Board - Semi-Private - Three and Four Beds
0138 Rehabilitation - REHAB/3&4BED
Room & Board - Semi-Private - Three and Four Beds
0139 Other - OTHER/3&4BED
Room & Board - Semi-Private - Three and Four Beds
0150 General Classification - ROOM-BOARD/WARD Room & Board - Ward
0151 Medical/Surgical/GYN - MED-SUR-GY/WARD Room & Board - Ward
0152 OB - OB/WARD Room & Board – Ward
0153 Pediatric - PEDS/WARD Room & Board – Ward
Code Description
Category
0156 Detoxification - DETOX/WARD Room & Board – Ward
0157 Oncology - ONCOLOGY/WARD Room & Board – Ward
0158 Rehabilitation - REHAB/WARD Room & Board – Ward
0159 Other - OTHER/WARD Room & Board – Ward
0170 General Classification - NURSERY Nursery
0171 Newborn – Level I - NURSERY/LEVELI Nursery
0172 Newborn – Level II - NURSERY/LEVELII Nursery
0175 Neonatal ICU
0179 Other Nursery - NURSERY/OTHER Nursery
0183 Therapeutic Leave - LOA/THERAPEUTIC Leave of Absence
0185 Hospital Bed Days LOA/HOSPITAL BED DAYS Leave of Absence
0200 General Classification - INTENSIVE CARE (or ICU) Intensive Care
0201 Surgical - ICU/SURGICAL Intensive Care
0202 Medical - ICU/MEDICAL Intensive Care
0203 Pediatric - ICU PEDS Intensive Care
Psychiatric - ICU/PSTAY Intensive Care
0206 Intermediate ICU - ICU/INTERMEDIATE Intensive Care
0207 Burn Care - ICU/BURN CARE Intensive Care
0208 Trauma - ICU/TRAMA Intensive Care
0209 Other Intensive Care - ICU/OTHER Intensive Care
0210 General Classification - CORONARY CARE (or CCU) Coronary Care
0211 Myocardial Infarction - CCU/MYO INFARC Coronary Care
0212 Pulmonary Care - CCU/PULMONARY Coronary Care
0213 Heart Transplant - CCU/TRANSPLANT Coronary Care
0214 Intermediate CCU - CCU/INTERMEDIATE Coronary Care
0219 Other Coronary Care - CCU/OTHER Coronary Care
0250 General Classification - PHARMACY Pharmacy (Also see 063X, an extension of 025X)
0251 Generic Drugs -DRUGS/GENERIC
Pharmacy (Also see 063X, an extension of 025X)
0252 Non-generic Drugs - DRUGS/NONGENERIC
Pharmacy (Also see 063X, an extension of 025X)
0254 Drugs Incident to Other - DRUGS/INCIDENT ODX
Pharmacy (Also see 063X, an extension of 025X)
0255 Drugs Incident to Radiology - DRUGS/INCIDENT RAD
Pharmacy (Also see 063X, an extension of 025X)
0257 Non-prescription - DRGS/NONPSCRPT Pharmacy (Also see 063X, an extension of 025X)
0258 IV Solutions - IV SOLUTIONS
Pharmacy (Also see 063X, an extension of 025X)
Code Description
Category
0259 Other Pharmacy - DRGS/OTHER Pharmacy (Also see 063X, an extension of 025X)
0260 General Classification - IV THERAPY IV Therapy
0261 Infusion Pump - IV THER/INFSN PUMP IV Therapy
0262 IV Therapy/Pharmacy Svcs - IV THER/PHARM/SVC IV Therapy
0263 IV Therapy/Drug/Supply Delivery IV THER/DRUG/SUPPLY DELV IV Therapy
0264 IV Therapy/Supplies - IV THER/SUPPLIES IV Therapy
0269 Other IV Therapy - IV THERAPY/OTHER IV Therapy
0270 General Classification MED-SUR SUPPLIES
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0271 Non Sterile Supply NON-STER SUPPLY
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0272 Sterile Supply STERILE SUPPLY
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0274 Prosthetic/Orthotic Devices PROSTH/ORTH DEV
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0275 Pacemaker PACE MAKER
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0276 Intraocular Lens INTRA OC LENS
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0278 Other Implant (a) SUPPLY/IMPLANTS
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0279 Other Supplies/Devices SUPPLY/OTHER
Medical/Surgical Supplies and Devices (also see 062X, an extension of 027X)
0280 General Classification ONCOLOGY Oncology
0289 Other Oncology ONCOLOGY/OTHER Oncology
0300 General Classification LABORATORY or (LAB) Laboratory
0301 Chemistry LAB/CHEMISTRY Laboratory
0302 Immunology LAB/IMMUNOLOGY Laboratory
0304 Non-Routine Dialysis LAB/NR DIALYSIS Laboratory
0305 Hematology LAB/HEMATOLOGY Laboratory
Code Description
Category
0307 Urology - LAB/UROLOGY Laboratory
0309 Other Laboratory - LAB/OTHER Laboratory
0310
General Classification - PATHOLOGY LAB or (PATH
LAB) Laboratory Pathological
0311 Cytology - PATHOL/CYTOLOGY Laboratory Pathological
0312 Histology - PATHOL/HYSTOL Laboratory Pathological
0314 Biopsy -PATHOL/BIOPSY Laboratory Pathological
0319 Other Laboratory Pathological PATHOL/OTHER Laboratory Pathological
0320 General Classification DX X-RAY Radiology - Diagnostic
0321 Angiocardiography DX X-RAY/ANGIO Radiology - Diagnostic
0322 Arthrography DX X-RAY/ARTH Radiology - Diagnostic
0323 Arteriography DX X-RAY/ARTER Radiology - Diagnostic
0324 Chest X-Ray DX X-RAY/CHEST Radiology - Diagnostic
0329 Other Radiology - Diagnostic DX X-RAY/OTHER Radiology - Diagnostic
0330 General Classification RX X-RAY
Radiology - Therapeutic and/or Chemotherapy Administration
0331 Chemotherapy Administration - CHEMOTHER/INJ
Radiology - Therapeutic and/or Chemotherapy Administration
0332 Chemotherapy Administration - CHEMOTHER/ORAL
Radiology - Therapeutic and/or Chemotherapy Administration
0333 Radiation Therapy RADIATION RX
Radiology - Therapeutic and/or Chemotherapy Administration
0335 Chemotherapy Administration - IV CHEMOTHERP-IV
Radiology - Therapeutic and/or Chemotherapy Administration
0339 Other Radiology - Therapeutic RX X-RAY/OTHER
Radiology - Therapeutic and/or Chemotherapy Administration
0340
General Classification - NUCLEAR MEDICINE or
(NUC MED) Nuclear Medicine
0341 Diagnostic - NUC MED/DX Nuclear Medicine
0342 Therapeutic - NUC MED/RX Nuclear Medicine
0349 Other Nuclear Medicine - NUC MED/OTHER Nuclear Medicine
0350 General Classification - CT SCAN CT Scan
0351 Head Scan - CT SCAN/HEAD CT Scan
0352 Body Scan - CT SCAN/BODY CT Scan
Code Description
Category
0360 General Classification - OR SERVICES Operating Room Services
0361 Minor Surgery - OR/MINOR Operating Room Services
0362
Organ Transplant-Other Than - OR/ORGAN TRANS
Kidney Operating Room Services
0367 Kidney Transplant - OR/KIDNEY TRANS Operating Room Services
0369 Other Operating Room - OR/OTHER Operating Room Services
0370 General Classification - ANESTHESIA Anesthesia
0371
Anesthesia Incident to Radiology
ANESTHE/INCIDENT RAD Anesthesia
0372 Anesthesia Incident to Other - ANESTHE/INCDNT OTHER DX Anesthesia
0379 Other Anesthesia - ANESTHE/OTHER Anesthesia
0380 General Classification BLOOD Blood
0381 Packed Red Cells BLOOD/PKD RED Blood
0382 Whole Blood BLOOD/WHOLE Blood
0383 Plasma BLOOD/PLASMA Blood
0384 Platelets BLOOD/PLATELETS Blood
0385 Leucocytes BLOOD/LEUCOCYTES Blood
0386 Other Components BLOOD/COMPONENTS Blood
0387
Other Derivatives BLOOD/DERIVATIVES
(Cryopricipitates) Blood
0389 Other Blood BLOOD/OTHER Blood
0390 General Classification BLOOD/STOR-PROC
Blood and Blood
Component Administration, Processing and Storage
0391 Administration (e.g., Transfusions) BLOOD/ADMIN
Blood and Blood
Component Administration, Processing and Storage
0399 Other Processing and Storage BLOOD/OTHER STOR
Blood and Blood
Component Administration, Processing and Storage
0400 General Classification - IMAGE SERVICE Other Imaging Services
0401 Diagnostic Mammography - DIAG MAMMOGRAPHY Other Imaging Services
0402 Ultrasound - ULTRASOUND Other Imaging Services
0403 Screening Mammography* - SCRN MAMMOGRAPHY Other Imaging Services
0404 Positron Emission Tomography - PET SCAN Other Imaging Services
0409 Other Imaging Service - OTHER IMAG SVS Other Imaging Services
0410 General Classification - RESPIRATORY SVC Respiratory Services
0412 Inhalation Services - INHALATION SVC Respiratory Services
Code Description
Category
0419 Other Respiratory Services - OTHER RESPIR SVS Respiratory Services
0420 General Classification - PHYSICAL THERP Physical Therapy
0421 Visit Charge - PHYS THERP/VISIT Physical Therapy
0422 Hourly Charge - PHYS THERP/HOUR Physical Therapy
0423 Group Rate - PHYS THERP/GROUP Physical Therapy
0424 Evaluation or Re-evaluation - PHYS THERP/EVAL Physical Therapy
0429 Other Physical Therapy - OTHER PHYS THERP Physical Therapy
0430 General Classification - OCCUPATION THER Occupational Therapy
0431 Visit Charge - OCCUP THERP/VISIT Occupational Therapy
0432 Hourly Charge - OCCUP THERP/HOUR Occupational Therapy
0433 Group Rate - OCCUP THERP/GROUP Occupational Therapy
0434 Evaluation or Re-evaluation - OCCUP THERP/EVAL Occupational Therapy
0439 Other Occupational Therapy - OTHER OCCUP THER Occupational Therapy
0440 General Classification - SPEECH PATHOL Speech-Language Pathology
0441 Visit Charge - SPEECH PATH/VISIT Speech-Language Pathology
0442 Hourly Charge - SPEECH PATH/HOUR Speech-Language Pathology
0443 Group Rate - SPEECH PATH/GROUP Speech-Language Pathology
0444 Evaluation or Re-evaluation - SPEECH PATH/EVAL Speech-Language Pathology
0449 Other Speech-Language - OTHER SPEECH PAT Speech-Language Pathology
0450 General Classification - EMERG ROOM Emergency Room
0459 Other Emergency Room - OTHER EMER ROOM Emergency Room
0460 General Classification - PULMONARY FUNC Pulmonary Function
0469 Other Pulmonary Function - OTHER PULMON FUNC Pulmonary Function
0470 General Classification - AUDIOLOGY Audiology
0471 Diagnostic - AUDIOLOGY/DX Audiology
0472 Treatment - AUDIOLOGY/RX Audiology
0479 Other Audiology - OTHER AUDIOL Audiology
0480 General Classification - CARDIOLOGY Cardiology
0481 Cardiac Cath Lab - CARDIAC CATH LAB Cardiology
0482 Stress Test - STRESS TEST Cardiology
0489 Other Cardiology - OTHER CARDIOL Cardiology
0549 Other Ambulance - OTHER AMBULANCE Ambulance
0610 General Classification - MRI Magnetic Resonance Technology (MRT)
0611 MRI - Brain (Including Brainstem) MRI - BRAIN
Magnetic Resonance Technology (MRT)
0612 MRI - Spinal Cord (Including Spine) MRI - SPINE Magnetic Resonance Technology (MRT)
0619 Other MRI - MRI- OTHER
Magnetic Resonance Technology (MRT)
Code Description
Category
0700 General Classification - CAST ROOM Cast Room
0709 Other Cast Room - OTHER CAST ROOM Cast Room
0710 General Classification - RECOVERY ROOM Recovery Room
0719 Other Recovery Room - OTHER RECOV RM Recovery Room
0720 General Classification - DELIVEROOM/LABOR Labor Room/Delivery
0721 Labor Labor Room/Delivery
0722 Delivery - DELIVERY ROOM Labor Room/Delivery
0723 Circumcision Labor Room/Delivery
0724 Birthing Center Labor Room/Delivery
0729 Other Labor Room/Delivery - OTHER/DELIV-LABOR Labor Room/Delivery
0730 General Classification - EKG/ECG EKG/ECG (Electrocardiogram)
0731 Holter Monitor - HOLTER MONT
EKG/ECG
(Electrocardiogram)
0732 Telemetry EKG/ECG (Electrocardiogram)
0739 Other EKG/ECG
EKG/ECG
(Electrocardiogram)
0740 General Classification - EEG EEG (Electroencephalogram)
0749 Other EEG - OTHER EEG
EEG
(Electroencephalogram)
0750 General Classification - GASTR-INST SVS Gastro-Intestinal Services
0759 Other Gastro-Intestinal - OTHER GASTRO-INTS Gastro-Intestinal Services
0760 General Classification TREATMENT/OBSERVATION RM Treatment/Observation Room 0761 Treatment Room Treatment/Observation Room
0762 Observation Room Treatment/Observation Room
0769
Other Treatment/Observation Room OTHER TREAT/OBSERV RM
Treatment/Observation Room
0790 General Classification - LITHOTRIPSY Lithotripsy
0799 Other Lithotripsy - LITHOTRIPSY/OTHER Lithotripsy
0800 General Classification - RENAL DIALYSIS Inpatient Renal Dialysis
0801 Inpatient Hemodialysis -DIALY/INPT Inpatient Renal Dialysis
0802 Inpatient Peritoneal - DIALY/INPT/PER (Non-CAPD) Inpatient Renal Dialysis
0803
Inpatient Continuous - DIALY/INPT/CAPD
Code Description
Category
0804 Inpatient Continuous DIALY/INPT/CCPD Cycling Peritoneal Dialysis (CCPD) Inpatient Renal Dialysis
0809 Other Inpatient Dialysis - DIALY/INPT/OTHER Inpatient Renal Dialysis
0810 General Classification - ORGAN ACQUISIT Acquisition of Body Components
0811 Living Donor Acquisition of Body Components 0812 Cadaver Donor Acquisition of Body Components 0813 Unknown donor Acquisition of Body Components 0819 Other Donor Acquisition of Body Components
0880 General Classification - DIALY/MISC Miscellaneous Dialysis
0881 Ultrafiltration - DIALY/ULTRAFILT Miscellaneous Dialysis
0889 Other Miscellaneous Dialysis - DIALY/MISC/OTHER Miscellaneous Dialysis
0900 General Classification PSYCH TREATMENT
Psychiatric/Psychological Treatments
0901 Electroshock Treatment ELECTRO SHOCK
Psychiatric/Psychological Treatments
0902 Milieu Therapy MILIEU THERAPY
Psychiatric/Psychological Treatments
0903 Play Therapy PLAY THERAPY
Psychiatric/Psychological Treatments
0904 Activity Therapy ACTIVITY THERAPY
Psychiatric/Psychological Treatments
0909 Other Psychiatric/Psychological OTHER PSYCH RX Psychiatric/Psychological Treatments
0910 General Classification - PSYCH SERVICES
Psychiatric/Psychological Services
0911 Rehabilitation - PSYCH/REHAB Psychiatric/Psychological Services
0914 Individual Therapy - PSYCH/INDIV RX
Psychiatric/Psychological Services
0915 Group Therapy - PSYCH/GROUP RX Psychiatric/Psychological Services
0916 Family Therapy - PSYCH/FAMILY RX
Psychiatric/Psychological Services
Revenue
Code Description
Category
0918 Testing - PSYCH/TESTING
Psychiatric/Psychological Services
0919 Other Psychiatric/Psychological PSYCH/OTHER Psychiatric/Psychological Services
0920 General Classification - OTHER DX SVS Other Diagnostic Services
0921 Peripheral Vascular Lab - PERI VASCUL LAB Other Diagnostic Services
0922 Electromyelogram - EMG Other Diagnostic Services
0923 Pap Smear - PAP SMEAR Other Diagnostic Services
0924 Allergy Test - ALLERGY TEST Other Diagnostic Services
0925 Pregnancy Test - PREG TEST Other Diagnostic Services
0929 Other Diagnostic Service - ADDITIONAL DX SVS Other Diagnostic Services
0940 General Classification - OTHER RX SVS
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0941 Recreational Therapy - RECREATION RX
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0942 Education/Training - EDUC/TRAINING
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0943 Cardiac Rehabilitation - CARDIAC REHAB
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0944 Drug Rehabilitation - DRUG REHAB
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0945 Alcohol Rehabilitation - ALCOHOL REHAB
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0946
Complex Medical Equipment - CMPLX MED EQUIP-ROUT
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0947
Complex Medical Equipment - CMPLX MED EQUIP-ANC
Other Therapeutic Services (Also see 095X, an
extension of 094X)
0949 Other Therapeutic Service - ADDITIONAL RX SVS
Other Therapeutic Services (Also see 095X, an
Revenue
Code Description
Category
0964 Anesthetist (CRNA) - PRO FEE/ANES CRNA
Professional Fees (also see 097X and 098X)
0976 Respiratory Therapy - PRO FEE/RESPIR
Professionals Fees (Extension of 096X)
0977 Physical Therapy - PRO FEE/PHYSI
Professionals Fees (Extension of 096X)
0978 Occupational Therapy - PRO FEE/OCCUPA
Professionals Fees (Extension of 096X)
0979 Speech Pathology - PRO FEE/SPEECH
Professionals Fees (Extension of 096X)
