Revenue code categories
Revenue code categories are available as grouping/sorting/filtering criteria in Charges and Costs Detail, Physician Service Details, Treatment Analysis, and Details section. You may also be interested in Revenue code measures.
| Revenue code | UB-04 category | Code description | Clinical Analytics category | Clinical Analytics costs/charges measure(s) | Clinical Analytics Days Measure(s) | Clinical Analytics Usage Measure(s) |
|---|---|---|---|---|---|---|
| 0001 | Total Charge | Total Charges | Total | Total Charges; Total Costs | ||
|
0100 |
010x: All-inclusive Rate | All-inclusive room and board plus ancillary | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0101 | All-inclusive room and board | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0110 | 011x: Room & Board - Private (One Bed) | General Classification: Room & Board - Private (One Bed) | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | |
| 0111 | Medical/Surgical/Gynocological | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0112 | Obstetrics (OB) | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0113 | Pediatric | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0114 | Psychiatric | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0115 | Hospice | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0116 | Detoxification | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0117 | Oncology | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0118 | Rehabilitation | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0119 | Other | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0120 | 012x: Room & Board - Semi-Private (Two Beds) | General Classification: Room & Board - Semi-private (Two Beds) | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0121 | Medical/Surgical/Gynocological | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0122 | Obstetrics (OB) | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0123 | Pediatric | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0124 | Psychiatric | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0125 | Hospice | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0126 | Detoxification | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0127 | Oncology | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0128 | Rehabilitation | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0129 | Other | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0130 | 013x: Room & Board: Three and Four Beds | General Classification: Room & Board - Three and Four Beds | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0131 | Medical/Surgical/Gynocological | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0132 | Obstetrics (OB) | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0133 | Pediatric | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0134 | Psychiatric | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0135 | Hospice | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0136 | Detoxification | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0137 | Oncology | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0138 | Rehabilitation | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0139 | Other | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0140 | 014x: Room & Board - Deluxe Private | General Classification: Room & Board - Deluxe Private | Room & Board | Total Accommodations; Accommodations - Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0141 | Medical/Surgical/Gynocological | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0142 | Obstetrics (OB) | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0143 | Pediatric | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0144 | Psychiatric | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0145 | Hospice | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0146 | Detoxification | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0147 | Oncology | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0148 | Rehabilitation | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0149 | Other | Room & Board | Total Accommodations; Accommodations - Private | Private; Private, Semi-Private, and Ward | ||
| 0150 | 015x: Room & Board - Ward | General Classification: Room & Board - Ward | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | |
| 0151 | Medical/Surgical/Gynocological | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0152 | Obstetrics (OB) | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0153 | Pediatric | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0154 | Psychiatric | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0155 | Hospice | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0156 | Detoxification | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0157 | Oncology | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0158 | Rehabilitation | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0159 | Other | Room & Board | Total Accommodations; Accommodations - Ward | Ward; Private, Semi-Private, and Ward | ||
| 0160 | 016x: Room & Board - Other | General Classification: Room & Board - Other | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0164 | Sterile Environment | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0167 | Self Care | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0169 | Other | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0170 | 017x: Nursery | General Classification: Nursery | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward; Nursery | |
| 0171 | Level I | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward; Nursery | ||
| 0172 | Level II | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward; Nursery | ||
| 0173 | Level III | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward; Nursery | ||
| 0174 | Level IV | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward; Nursery | ||
| 0179 | Other Nursery | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward; Nursery | ||
| 0180 | 018x: Leave of Absence | General Classification: Leave of absence | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0182 | Patient Convenience | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0183 | Therapeutic Leave | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0185 | Nursing Home (for Hospitalization) | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0189 | Other | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0190 | 019x: Subacute Care | General Classification: Subacute care | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | |
| 0191 | Level I | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0192 | Level II | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0193 | Level III | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0194 | Level IV | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0199 | Other | Room & Board | Total Accommodations; Accommodations - Semi-Private | Semi-Private; Private, Semi-Private, and Ward | ||
| 0200 | 020x: Intensive Care Unit | General Classification: Intensive Care Unit | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use |
| 0201 | Surgical | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0202 | Medical | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0203 | Pediatric | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0204 | Psychiatric | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0206 | Intermediate ICU | Intensive Care | Total Accommodations; Critical Care; Intermediate ICU/CCU | ICU; Critical Care; Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0207 | Burn Care | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0208 | Trauma | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0209 | Other | Intensive Care | Total Accommodations; ICU; Critical Care; Critical Care without Intermediate ICU/CCU | ICU; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; ICU Use | |
| 0210 | 021x: Coronary Care Unit | General Classification: Coronary Care Unit | Intensive Care | Total Accommodations; Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; CCU Use |
| 0211 | Myocardial Infarction | Intensive Care | Total Accommodations; Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; CCU Use | |
| 0212 | Pulmonary Care | Intensive Care | Total Accommodations; Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; CCU Use | |
| 0213 | Heart Transplant | Intensive Care | Total Accommodations; Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; CCU Use | |
| 0214 | Intermediate CCU | Intensive Care | Total Accommodations; Coronary Care; Critical Care; Intermediate ICU/CCU | Coronary Care; Critical Care; Intermediate ICU/CCU | Critical Care Use; CCU Use | |
| 0219 | Other | Intensive Care | Total Accommodations; Critical Care; Coronary Care; Critical Care without Intermediate ICU/CCU | Coronary Care; Critical Care; Critical Care without Intermediate ICU/CCU | Critical Care Use; CCU Use | |
| 0220 | 022x: Special Charges | General Classification: Special Charges | Special Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0221 | Admission Charges | Special Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0222 | Technical Support Charge | Special Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0223 | U.R. Service Charge | Special Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0224 | Late Discharge, Medically Necessary | Special Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0229 | Other Special Charges | Special Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0230 | 023x: Incremental Nursing Charge | General Classification: Incremental Nursing Charge | Room & Board | Nursery & NICU; Other | ||
| 0231 | Nursery | Room & Board | Nursery & NICU; Other | |||
| 0232 | OB | Room & Board | Nursery & NICU; Other | |||
| 0233 | ICU | Room & Board | Nursery & NICU; Other | |||
| 0234 | CCU | Room & Board | Nursery & NICU; Other | |||
| 0235 | Hospice | Room & Board | Nursery & NICU; Other | |||
| 0239 | Other | Room & Board | Nursery & NICU; Other | |||
| 0240 | 024x: All Inclusive Ancillary | General Classification: All Inclusive Ancillary | Room & Board | Nursery & NICU; Other | ||
| 0241 | Basic | Room & Board | ||||
| 0242 | Comprehensive | Room & Board | ||||
| 0243 | Specialty | Room & Board | ||||
| 0249 | Other All Inclusive Ancillary | Room & Board | Nursery & NICU; Other | |||
| 0250 | 025x: Pharmacy | General Classification: Pharmacy | Pharmacy | Pharmacy | ||
| 0251 | Generic Drugs | Pharmacy | Pharmacy | |||
| 0252 | Non-Generic Drugs | Pharmacy | Pharmacy | |||
| 0253 | Take Home Drugs | Pharmacy | Pharmacy | |||
| 0254 | Drugs Incident to Other Diagnostic Services | Pharmacy | Pharmacy | |||
| 0255 | Drugs Incident to Radiology | Pharmacy | Pharmacy | |||
| 0256 | Experimental Drugs | Pharmacy | Pharmacy | |||
| 0257 | Non-Prescription | Pharmacy | Pharmacy | |||
| 0258 | IV Solutions | Pharmacy | Pharmacy | |||
| 0259 | Other Pharmacy | Pharmacy | Pharmacy | |||
| 0260 | 026x: IV Therapy | General Classification: IV Therapy | Supplies | Pharmacy | ||
| 0261 | Infusion Pump | Supplies | Pharmacy | |||
| 0262 | Pharmacy Services | Supplies | Pharmacy | |||
| 0263 | Drug/Supply/Delivery | Supplies | Pharmacy | |||
| 0264 | Supplies | Supplies | Pharmacy | |||
| 0269 | Other IV Therapy | Supplies | Pharmacy | |||
| 0270 | 027x: Medical/Surgical Supplies and Devices | General Classification: Medical/Surgical Supplies and Devices | Supplies | Medical/Surgical Supplies | ||
| 0271 | Non-sterile Supply | Supplies | Medical/Surgical Supplies | |||
| 0272 | Sterile Supply | Supplies | Medical/Surgical Supplies | |||
| 0273 | Take Home Supplies | Supplies | Medical/Surgical Supplies | |||
| 0274 | Prosthetic/Orthotic Supplies | Supplies | Medical/Surgical Supplies | |||
| 0275 | Pacemaker | Supplies | Medical/Surgical Supplies | |||
| 0276 | Intraocular Lens | Supplies | Medical/Surgical Supplies | |||
| 0277 | Oxygen - Take Home | Supplies | Medical/Surgical Supplies | |||
| 0278 | Other Implant | Supplies | Medical/Surgical Supplies | |||
| 0279 | Other Supplies/Devices | Supplies | Medical/Surgical Supplies | |||
| 0280 | 028x: Oncology | General Classification: Oncology | Therapeutic Services | Oncology; Radiology, CT Scan, Oncology & Nuclear Medicine | ||
| 0289 | Other Oncology | Therapeutic Services | Oncology; Radiology, CT Scan, Oncology & Nuclear Medicine | |||
| 0290 | 029x: Durable Medical Equipment (other than renal) | General Classification: Durable Medical Equipment (other than renal) | Supplies | Durable Medical Equipment | ||
| 0291 | Rental | Supplies | Durable Medical Equipment | |||
| 0292 | Purchase of New DME | Supplies | Durable Medical Equipment | |||
| 0293 | Purchase of Used DME | Supplies | Used Durable Medical Equipment | |||
| 0294 | Supplies/Drugs for DME | Supplies | Durable Medical Equipment | |||
| 0299 | Other Equipment | Supplies | Durable Medical Equipment | |||
| 0300 | 030x: Laboratory | General Classification: Laboratory | Diagnostic Services | Laboratory & Pathology | ||
| 0301 | Chemistry | Diagnostic Services | Laboratory & Pathology | |||
| 0302 | Immunology | Diagnostic Services | Laboratory & Pathology | |||
| 0303 | Renal Patient (Home) | Diagnostic Services | Laboratory & Pathology | |||
| 0304 | Non-Routine Dialysis | Diagnostic Services | Laboratory & Pathology | |||
| 0305 | Hematology | Diagnostic Services | Laboratory & Pathology | |||
| 0306 | Bacteriology & Microbiology | Diagnostic Services | Laboratory & Pathology | |||
| 0307 | Urology | Diagnostic Services | Laboratory & Pathology | |||
| 0309 | Other Laboratory | Diagnostic Services | Laboratory & Pathology | |||
| 0310 | 031x: Laboratory Pathology | General Classification: Laboratory Pathology | Diagnostic Services | Laboratory & Pathology; Pathology | ||
| 0311 | Cytology | Diagnostic Services | Laboratory & Pathology; Pathology | |||
| 0312 | Histology | Diagnostic Services | Laboratory & Pathology; Pathology | |||
| 0314 | Biopsy | Diagnostic Services | Laboratory & Pathology; Pathology | |||
| 0319 | Other Laboratory Pathology | Diagnostic Services | Laboratory & Pathology; Pathology | |||
| 0320 | 032x: Radiology - Diagnostic | General Classification: Radiology - Diagnostic | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | |
| 0321 | Angiocardiology | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0322 | Arthrography | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0323 | Arteriography | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0324 | Chest X-Ray | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0329 | Other Radiology - Diagnostic | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0330 | 033x: Radiology - Therapeutic and/or Chemotherapy Administration | General Classification: Radiology - Therapeutic and/or Chemotherapy Administration |
Therapeutic Services |
Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | |
| 0331 | Chemotherapy Administration - Injected |
Therapeutic Services |
Oncology; Radiology, CT Scan, Oncology & Nuclear Medicine | |||
| 0332 | Chemotherapy Administration - Oral |
Therapeutic Services |
Oncology; Radiology, CT Scan, Oncology & Nuclear Medicine | |||
| 0333 | Radiation Therapy |
Therapeutic Services |
Oncology; Radiology, CT Scan, Oncology & Nuclear Medicine | |||
| 0335 | Chemotherapy Administration - IV |
Therapeutic Services |
Oncology; Radiology, CT Scan, Oncology & Nuclear Medicine | |||
| 0339 | Other Radiology - Therapeutic |
Therapeutic Services |
Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0340 | 034x: Nuclear Medicine | General Classification: Nuclear Medicine | Diagnostic Services | Nuclear Medicine; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | |
| 0341 | Diagnostic | Diagnostic Services | Nuclear Medicine; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0342 | Therapeutic | Diagnostic Services | Nuclear Medicine; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0343 | Diagnostic Radiopharmaceuticals | Diagnostic Services | ||||
| 0344 | Therapeutic Radiopharmaceulticals | Diagnostic Services | ||||
| 0349 | Other Nuclear Medicine | Diagnostic Services | Nuclear Medicine; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0350 | 035x: CT Scan | General Classification: SC Scan | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use; CT Use | |
| 0351 | CT - Head Scan | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use; CT Use | ||
| 0352 | CT - Body Scan | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use; CT Use | ||
| 0359 | CT - Other | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use; CT Use | ||
| 0360 | 036x: Operating Room Services | General Classification: Operating Room Services | Operating Room | Operating Room, Labor & Delivery | ||
| 0361 | Minor Surgery | Operating Room | Operating Room, Labor & Delivery | |||
| 0362 | Organ Transplant - Other than Kidney | Operating Room | Operating Room, Labor & Delivery | |||
| 0367 | Kidney Transplant | Operating Room | Operating Room, Labor & Delivery | |||
| 0369 | Other OR Services | Operating Room | Operating Room, Labor & Delivery | |||
| 0370 | 037x: Anesthesia | General Classification: Anesthesia | Operating Room | Anesthesiology | ||
| 0371 | Anesthesia Incident to Radiology | Operating Room | Anesthesiology | |||
| 0372 | Anesthesia Incident to Other Diagnostic Services | Operating Room | Anesthesiology | |||
| 0374 | Acupuncture | Operating Room | Anesthesiology | |||
| 0379 | Other Anesthesia | Operating Room | Anesthesiology | |||
| 0380 | 038x: Blood and Blood Components | General Classification: Blood and Blood Components | Supplies | Blood Use | Blood Use | |
| 0381 | Packaged Red Cells | Supplies | Blood Use | Blood Use | ||
| 0382 | Whole Blood | Supplies | Blood Use | Blood Use | ||
| 0383 | Plasma | Supplies | Blood Use | Blood Use | ||
| 0384 | Platelets | Supplies | Blood Use | Blood Use | ||
| 0385 | Leukocytes | Supplies | Blood Use | Blood Use | ||
| 0386 | Other Blood Components | Supplies | Blood Use | Blood Use | ||
| 0387 | Other Derivatives (Cryoprecipitate) | Supplies | Blood Use | Blood Use | ||
| 0389 | Other Blood and Blood Components | Supplies | Blood Use | Blood Use | ||
| 0390 | 039x: Administration, Processing, and Storage for Blood and Blood Components | General Classification: Administration, Processing, and Storage for Blood and Blood Components | Supplies | Blood Administration | Blood Use | |
| 0391 | Administration (e.g., Transfusion) | Supplies | Blood Administration | Blood Use | ||
| 0392 | Processing and Storage | |||||
| 0399 | Other Blood Handling | Supplies | Blood Administration | Blood Use | ||
| 0400 | 040x: Other Imaging Services | General Classification: Other Imaging Services | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | |
| 0401 | Diagnostic Mammography | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0402 | Ultrasound | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0403 | Screening Mammography | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0404 | Positron Emission Tomography | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0409 | Other Imaging Services | Diagnostic Services | Radiology & CT Scan; Radiology, CT Scan, Oncology & Nuclear Medicine | Radiology Use | ||
| 0410 | 041x: Respiratory Services | General Classification: Respiratory Services |
Therapeutic Services |
Respiratory Services; Respiratory Therapy | ||
| 0412 | Inhalation Services |
Therapeutic Services |
Respiratory Services; Respiratory Therapy | |||
| 0413 | Hyperbaric Oxygen Therapy |
Therapeutic Services |
Respiratory Services; Respiratory Therapy | |||
| 0419 | Other Respiratory Services |
Therapeutic Services |
Respiratory Services; Respiratory Therapy | |||
| 0420 | 042x: Physical Therapy | General Classification: Physical Therapy |
Therapeutic Services |
Physical Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | |
| 0421 | Visit |
Therapeutic Services |
Physical Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0422 | Hourly |
Therapeutic Services |
Physical Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0423 | Group |
Therapeutic Services |
Physical Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0424 | Evaluation or Re-evaluation |
Therapeutic Services |
Physical Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0429 | Other Physical Therapy |
Therapeutic Services |
Physical Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0430 | 043x: Occupational Therapy | General Classification: Occupational Therapy |
Therapeutic Services |
Occupational Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | |
| 0431 | Visit |
Therapeutic Services |
Occupational Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0432 | Hourly |
Therapeutic Services |
Occupational Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0433 | Group |
Therapeutic Services |
Occupational Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0434 | Evaluation or Re-evaluation |
Therapeutic Services |
Occupational Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0439 | Other Occupational Therapy |
Therapeutic Services |
Occupational Therapy; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0440 | 044x: Speech Therapy - Language Pathology | General Classification: Speech Therapy - Language Pathology |
Therapeutic Services |
Speech Pathology; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | |
| 0441 | Visit |
Therapeutic Services |
Speech Pathology; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0442 | Hourly |
Therapeutic Services |
Speech Pathology; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0443 | Group |
Therapeutic Services |
Speech Pathology; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0444 | Evaluation or Re-evaluation |
Therapeutic Services |
Speech Pathology; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0449 | Other Speech Therapy |
Therapeutic Services |
Speech Pathology; Therapy: Physical, Occupational, Speech | PT, OT and Speech Therapy Use | ||
| 0450 | 045x: Emergency Room | General Classification: Emergency Room | Emergency Room | Emergency Department | ||
| 0451 | EMTALA Emergency Medical Screening | Emergency Room | Emergency Department | |||
| 0452 | ER Beyond EMTALA | Emergency Room | Emergency Department | |||
| 0456 | Urgent Care | Emergency Room | Emergency Department | |||
| 0459 | Other Emergency Room | Emergency Room | Emergency Department | |||
| 0460 | 046x: Pulmonary Function | General Classification: Pulmonary Function | Diagnostic Services | Respiratory Therapy | ||
| 0469 | Other Pulmonary Function | Diagnostic Services | Respiratory Therapy | |||
| 0470 | 047x: Audiology | General Classification: Audiology |
Therapeutic Services |
Speech Pathology | ||
| 0471 | Diagnostic |
Therapeutic Services |
Speech Pathology | |||
| 0472 | Treatment |
Therapeutic Services |
Speech Pathology | |||
| 0479 | Other Audiology |
Therapeutic Services |
Speech Pathology | |||
| 0480 | 048x: Cardiology | General Classification: Cardiology | Therapeutic Services | Cardiology | ||
| 0481 | Cardiac Cath Lab | Therapeutic Services | Cardiology | |||
| 0482 | Stress Test | Therapeutic Services | Cardiology | |||
| 0483 | Echocardiology | Therapeutic Services | Cardiology | |||
| 0489 | Other Cardiology | Therapeutic Services | Cardiology | |||
| 0490 | 049x: Ambulatory Surgical Care | General Classification: Ambulatory Surgical Care | Operating Room | Outpatient Services | ||
| 0499 | Other Ambulatory Surgical Care | Operating Room | Outpatient Services | |||
| 0500 | 050x: Outpatient Services | General Classification: Outpatient Services | Other Charges | Outpatient Services | ||
| 0509 | Other Outpatient Service | Other Charges | Outpatient Services | |||
| 0510 | 051x: Clinic | General Classification: Clinic | Clinical Services | Clinic Visit | ||
| 0511 | Chronic Pain Clinic | Clinical Services | Clinic Visit | |||
| 0512 | Dental Clinic | Clinical Services | Clinic Visit | |||
| 0513 | Psychiatric Clinic | Clinical Services | Clinic Visit | |||
| 0514 | OB-GYN Clinic | Clinical Services | Clinic Visit | |||
| 0515 | Pediatric Clinic | Clinical Services | Clinic Visit | |||
| 0516 | Urgent Care Clinic | Clinical Services | Clinic Visit | |||
| 0517 | Family Practice Clinic | Clinical Services | Clinic Visit | |||
| 0519 | Other Clinic | Clinical Services | Clinic Visit | |||
| 0520 | 052x: Freestanding Clinic | General Classification: Freestanding Clinic | Clinical Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0521 | Clinic Visit by Member to RHC/FQHC | Clinical Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0522 | Home Visit by RHC/FQHC Practitioner | Clinical Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0523 | Family Practice Clinic | Clinical Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0524 | Visit by RHC/FQHC Practitioner to a Member in a SNF or Skilled Swing Bed in a Covered Part A Stay | Clinical Services | ||||
| 0525 | Visit by RHC/RQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility | Clinical Services | ||||
| 0526 | Urgent Care Clinic | Clinical Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0527 | Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area | Clinical Services | ||||
| 0528 | Visit by RHC/FQHC Site (for example, Scene of Accident) | Clinical Services | ||||
| 0529 | Other Freestanding Clinic | Clinical Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0530 | 053x: Osteopathic Services | General Classification: Osteopathic Services | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0531 | Osteopathic Therapy | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0539 | Other Osteopathic Services | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0540 | 054x: Ambulance | General Classification: Ambulance | Special Charges | Ambulance | ||
| 0541 | Supplies | Special Charges | Ambulance | |||
| 0542 | Medical Transport | Special Charges | Ambulance | |||
| 0543 | Heart Mobile | Special Charges | Ambulance | |||
| 0544 | Oxygen | Special Charges | Ambulance | |||
| 0545 | Air Ambulance | Special Charges | Ambulance | |||
| 0546 | Neonatal Ambulance Services | Special Charges | Ambulance | |||
| 0547 | Pharmacy | Special Charges | Ambulance | |||
| 0548 | EKG Transmission | Special Charges | Ambulance | |||
| 0549 | Other Ambulance | Special Charges | Ambulance | |||
| 0550 | 055x: Skilled Nursing | General Classification: Skilled Nursing | Room & Board | Other; Other Not Including Nursery & NICU & Psych | ||
| 0551 | Visit Charge | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0552 | Hourly Charge | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0559 | Other Skilled Nursing | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0560 | 056x: Home Health (HH) - Medical Social Services | General Classification: Home Health (HH) - Medical Social Services | Room & Board | Other; Other Not Including Nursery & NICU & Psych | ||
| 0561 | Visit Charge | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0562 | Hourly Charge | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0569 | Other Medical Social Service | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0570 | 057x: Home Health (HH) Aide | General Classification: Home Health (HH) Aide | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0571 | Visit Charge | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0572 | Hourly Charge | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0579 | Other Home Health Aide | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0580 | 058x: Home Health (HH) - Other Visits | General Classification: Home Health (HH) - Other Visits | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0581 | Visit Charge | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0582 | Hourly Charge | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0583 | Assessment | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0589 | Other Home Health Visit | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0590 | 059x: Home Health (HH) Units of Service | General Classification: Home Health (HH) Units of Service | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0600 | 060x: Home Health (HH) - Oxygen | General Classification: Home Health (HH) - Oxygen | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0601 | Oxygen - Stat Equipment/Supply/Content | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0602 | Oxygen - Stat Equipment/Supply<1 LPM | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0603 | Oxygen - Stat Equipment/Supply>4 LPM | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0604 | Oxygen - Portable Add-on | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0609 | Oxygen - Other | Home Health Services | ||||
| 0610 | 0610x: Magnetic Resonance Technology (MRT) | General Classification: Magnetic Resonance Technology (MRT) | Diagnostic Services | MRI | MRI Use | |
| 0611 | MRI - Brain/Brainstem | Diagnostic Services | MRI | MRI Use | ||
| 0612 | MRI - Spinal Cord/Spine | Diagnostic Services | MRI | MRI Use | ||
| 0614 | MRI - Other | Diagnostic Services | MRI | MRI Use | ||
| 0615 | MRA - Head and Neck | Diagnostic Services | MRI | MRI Use | ||
| 0616 | MRA - Lower Extremities | Diagnostic Services | MRI | MRI Use | ||
| 0618 | MRA - Other | Diagnostic Services | MRI | MRI Use | ||
| 0619 | Other MRT | Diagnostic Services | MRI | MRI Use | ||
| 0620 | 062x: Medical/Surgical Supplies and Devices | RESERVED: Use 0270 for General Classification of Medical/Surgical Supplies and Devices | ||||
| 0621 | Supplies Incident to Radiology | Supplies | Medical/Surgical Supplies | |||
| 0622 | Supplies Incident to Other Diagnostic Services | Supplies | Medical/Surgical Supplies | |||
| 0623 | Surgical Dressings | Supplies | Medical/Surgical Supplies | |||
| 0624 | FDA Investigational Devices | Supplies | Medical/Surgical Supplies | |||
| 0630 | 063x: Pharmacy | RESERVED: Use 0250 for General Classification of Pharmacy | Pharmacy | Pharmacy | ||
| 0631 | Single Source Drug | Pharmacy | Pharmacy | |||
| 0632 | Multiple Source Drug | Pharmacy | Pharmacy | |||
| 0633 | Restrictive Prescription | Pharmacy | Pharmacy | |||
| 0634 | Erythropoietin (EPO) <10,000 Units | Pharmacy | Pharmacy | |||
| 0635 | Erythropoietin (EPO) >=10,000 Units | Pharmacy | Pharmacy | |||
| 0636 | Drugs Requiring Detailed Coding | Pharmacy | Pharmacy | |||
| 0637 | Self-administerable Drugs | Pharmacy | Pharmacy | |||
| 0640 | 064x: Home IV Therapy Services | General Classification: Home IV Therapy Services | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0641 | Non-routine Nursing, Central Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0642 | IV Site Care, Central Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0643 | IV Start/Change, Peripheral Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0644 | Non-routine Nursing, Peripheral Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0645 | Training Patient/Caregiver, Central Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0646 | Training Disabled Patient, Central Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0647 | Training Patient/Caregiver, Peripheral Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0648 | Training Disabled Patient, Peripheral Line | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0649 | Other IV Therapy Services | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0650 | 065x: Hospice Service | General Classification: Hospice Service | Room & Board | Other; Other Not Including Nursery & NICU & Psych | ||
| 0651 | Routine Home Care | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0652 | Continuous Home Care | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0655 | Inpatient Respite Care | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0656 | General Inpatient Care Non-Respite | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0657 | Physician Services | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0658 | Hospice Room & Board - Nursing facility | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0659 | Other Hospice Service | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0660 | 066x: Respite Care | General Classification: Respite Care | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0661 | Hourly Charge - Nursing | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0662 | Hourly Charge - Aide/Homemaker/Companion | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0663 | Daily Respite Charge | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0669 | Other Respite Care | Home Health Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0670 | 067x: Outpatient Special Residence Charges | General Classification: Outpatient Special Residence Charges | Other Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0671 | Hospital based | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0672 | Contracted | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0679 | Other special residence charge | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0681 | 068x: Trauma Response | Level I Trauma | Other Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0682 | Level II Trauma | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0683 | Level III Trauma | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0684 | Level IV Trauma | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0689 | Other Trauma Response | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0690 | 069x: Pre-hospice/Palliative Care Services | General Classification: Pre-hospice/Palliative Care Services | ||||
| 0691 | Visit Charge | |||||
| 0692 | Hourly Charge | |||||
| 0693 | Evaluation | |||||
| 0694 | Consultation and Education | |||||
| 0695 | Inpatient Care | |||||
| 0696 | Physician Services | |||||
| 0699 | Other Pre-hospice/Palliative Care Services | |||||
| 0700 | 070x: Cast Room | General Classification: Cast Room | Room & Board | Other; Other Not Including Nursery & NICU & Psych | ||
| 0710 | 071x: Recovery Room | General Classification: Recovery Room | Room & Board | Operating Room, Labor & Delivery | ||
| 0720 | 072x: Labor Room/Delivery | General Classification: Labor Room/Delivery | Room & Board | Operating Room, Labor & Delivery | ||
| 0721 | Labor | Room & Board | Operating Room, Labor & Delivery | |||
| 0722 | Delivery Room | Room & Board | Operating Room, Labor & Delivery | |||
| 0723 | Circumcision | Special Charges | Operating Room, Labor & Delivery | |||
| 0724 | Birthing Center | Room & Board | Operating Room, Labor & Delivery | |||
| 0729 | Other Labor Room/Delivery | Room & Board | Operating Room, Labor & Delivery | |||
| 0730 | 073x: EKG/ECG (Electrocardiogram) | General Classification: EKG/ECG (Electrocardiogram) | Diagnostic Services | Cardiology | ||
| 0731 | Holter Monitor | Diagnostic Services | Cardiology | |||
| 0732 | Telemetry | Diagnostic Services | Cardiology | |||
| 0739 | Other EKG/ECG | Diagnostic Services | Cardiology | |||
| 0740 | 074x: EEG (Electroencephalogram) | General Classification: EEG (Electroencephalogram) | Diagnostic Services | Laboratory & Pathology | ||
| 0750 | 075x: Gastro-Intestinal (GI) Services | General Classification: Gastro-Intestinal (GI) Services | Room & Board | Laboratory & Pathology | ||
| 0760 | 076x: Specialty Services | General Classification: Specialty Services | Room & Board | Other; Other Not Including Nursery & NICU & Psych | ||
| 0761 | Treatment Room | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0762 | Observation Hours | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0769 | Other Specialty Services | Room & Board | Other; Other Not Including Nursery & NICU & Psych | |||
| 0770 | 077x: Preventive Care Services | General Classification: Preventive Care Services | Other Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0771 | Vaccine Administration | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0780 | 078x: Telemedicine | General Classification: Telemedicine | Telemedicine | Other; Other Not Including Nursery & NICU & Psych | ||
| 0790 | 079x: Extra-Corporeal Shock Wave Therapy (formerly Lithotripsy) | General Classification: Extra-Corporeal Shock Wave Therapy (formerly Lithotripsy) | Therapeutic Services | Lithotripsy | ||
| 0800 | 080x: Inpatient Renal Dialysis | General Classification: Inpatient Renal Dialysis | Dialysis | ESRD | ||
| 0801 | Inpatient Hemodialysis | Dialysis | ESRD | |||
| 0802 | Inpatient Peritoneal (Non-CAPD) | Dialysis | ESRD | |||
| 0803 | Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD) | Dialysis | ESRD | |||
| 0804 | Inpatient Continuous Cycling Peritoneal Dialysis (CCPD) | Dialysis | ESRD | |||
| 0809 | Other Inpatient Dialysis | Dialysis | ESRD | |||
| 0810 | 081x: Acquisition of Body Components | General Classification: Acquisition of Body Components | Other Charges | Organ Acquisition | ||
| 0811 | Living Donor | Other Charges | Organ Acquisition | |||
| 0812 | Cadaver Donor | Other Charges | Organ Acquisition | |||
| 0813 | Unknown Donor | Other Charges | Organ Acquisition | |||
| 0814 | Unsuccessful Organ Search - Donor Bank Charges | Other Charges | Organ Acquisition | |||
| 0815 | Stem Cells - Allogeneic | Other Charges | ||||
| 0819 | Other Donor | Other Charges | Organ Acquisition | |||
| 0820 | 082x: Hemodialysis - Outpatient or Home | General Classification: Hemodialysis - Outpatient or Home | Dialysis | ESRD | ||
| 0821 | Homodialysis Composite or Other Rate | Dialysis | ESRD | |||
| 0822 | Home Supplies | Dialysis | ESRD | |||
| 0823 | Home Equipment | Dialysis | ESRD | |||
| 0824 | Maintenance - 100% | Dialysis | ESRD | |||
| 0825 | Support Services | Dialysis | ESRD | |||
| 0826 | Hemodialysis - Shorter Duration | Dialysis | ||||
| 0829 | Other Outpatient Hemodialysis | Dialysis | ESRD | |||
| 0830 | 083x: Peritoneal Dialysis - Outpatient or Home | General Classification: Peritoneal Dialysis - Outpatient or Home | Dialysis | ESRD | ||
| 0831 | Peritoneal/Composite or Other Rate | Dialysis | ESRD | |||
| 0832 | Home Supplies | Dialysis | ESRD | |||
| 0833 | Home Equipment | Dialysis | ESRD | |||
| 0834 | Maintenance - 100% | Dialysis | ESRD | |||
| 0835 | Support Services | Dialysis | ESRD | |||
| 0839 | Other Outpatient Peritoneal Dialysis | Dialysis | ESRD | |||
| 0840 | 084x: Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home | General Classification: Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home | Dialysis | ESRD | ||
| 0841 | CAPD/Composite or Other Rate | Dialysis | ESRD | |||
| 0842 | Home Supplies | Dialysis | ESRD | |||
| 0843 | Home Equipment | Dialysis | ESRD | |||
| 0844 | Maintenance - 100% | Dialysis | ESRD | |||
| 0845 | Support Services | Dialysis | ESRD | |||
| 0849 | Other Outpatient CAPD | Dialysis | ESRD | |||
| 0850 | 085x: Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home | General Classification: Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home | Dialysis | ESRD | ||
| 0851 | CCPD/Composite or Other Rate | Dialysis | ESRD | |||
| 0852 | Home Supplies | Dialysis | ESRD | |||
| 0853 | Home Equipment | Dialysis | ESRD | |||
| 0854 | Maintenance - 100% | Dialysis | ESRD | |||
| 0855 | Support Services | Dialysis | ESRD | |||
| 0859 | Other Outpatient CCPD | Dialysis | ESRD | |||
| 0860 | 086x: Magnetoencephalography (MEG) | General Classification: Magnetoencephalography (MEG) | Dialysis | ESRD | ||
| 0861 | MEG | Dialysis | ESRD | |||
| 0880 | 088x: Miscellaneous Dialysis | General Classification: Miscellaneous Dialysis | Dialysis | ESRD | ||
| 0881 | Ultrafiltration | Dialysis | ESRD | |||
| 0882 | Home Dialysis Aid Visit | Dialysis | ESRD | |||
| 0889 | Other Miscellaneous Dialysis | Dialysis | ESRD | |||
| 0900 | 090x: Behavioral Health Treatment/Services | General Classification: Behavioral Health Treatment/Services | Behavioral Health | Psych Services; Other | ||
| 0901 | Electroshock Treatment | Behavioral Health | Psych Services; Other | |||
| 0902 | Milieu Therapy | Behavioral Health | Psych Services; Other | |||
| 0903 | Play Therapy | Behavioral Health | Psych Services; Other | |||
| 0904 | Activity Therapy | Behavioral Health | Psych Services; Other | |||
| 0905 | Intensive Outpatient Services - Psychiatric | Behavioral Health | Psych Services; Other | |||
| 0906 | Intensive Outpatient Services - Chemical | Behavioral Health | Psych Services; Other | |||
| 0907 | Community Behavioral Health Program (Day Treatment) | Behavioral Health | Psych Services; Other | |||
| 0910 | 091x: Behavioral Health Treatment/Services | RESERVED: Use 0900 for General Classification of Behavioral Health Treatment/Services | Behavioral Health | Psych Services; Other | ||
| 0911 | Rehabilitation | Behavioral Health | Psych Services; Other | |||
| 0912 | Partial Hospitalization - Less Intensive | Behavioral Health | Psych Services; Other | |||
| 0913 | Partial Hospitalization - Intensive | Behavioral Health | Psych Services; Other | |||
| 0914 | Individual Therapy | Behavioral Health | Psych Services; Other | |||
| 0915 | Group Therapy | Behavioral Health | Psych Services; Other | |||
| 0916 | Family Therapy | Behavioral Health | Psych Services; Other | |||
| 0917 | Bio Feedback | Behavioral Health | Psych Services; Other | |||
| 0918 | Testing | Behavioral Health | Psych Services; Other | |||
| 0919 | Other Behavioral Health Treatments | Behavioral Health | Psych Services; Other | |||
| 0920 | 092x: Other Diagnostic Services | General Classification: Other Diagnostic Services | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0921 | Peripheral Vascular Lab | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0922 | Electromyogram | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0923 | Pap Smear | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0924 | Allergy Test | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0925 | Pregnancy Test | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0929 | Other Diagnostic Service | Diagnostic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0931 | 093x: Medical Rehabilitation Day Program | Medical Rehabilitation Day Program: Half Day | Other Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0932 | Medical Rehabilitation Day Program: Full Day | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0940 | 094x: Other Therapeutic Services | General Classification: Other Therapeutic Services | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | ||
| 0941 | Recreational Therapy | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0942 | Education/Training | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0943 | Cardiac Rehabilitation | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0944 | Drug Rehabilitation | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0945 | Alcohol Rehabilitation | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0946 | Complex Medical Equipment - Routine | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0947 | Complex Medical Equipment - Ancillary | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0948 | Pulmonary Rehabilitation | Therapeutic Services | ||||
| 0949 | Other Therapeutic Service | Therapeutic Services | Other; Other Not Including Nursery & NICU & Psych | |||
| 0950 | 095x: Other Therapeutic Services | RESERVED: Use 0940 for General Classification of Other Therapeutic Services | Other Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0951 | Athletic Training | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0952 | Kinesiotherapy | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0953 | Chemical Dependency (Drug and Alcohol) | Other Charges | ||||
| 0960 | 096x: Professional Fees | General Classification: Professional Fees | Professional Fees | Professional Fee | ||
| 0961 | Psychiatric | Professional Fees | Professional Fee | |||
| 0962 | Opthalmology | Professional Fees | Professional Fee | |||
| 0963 | Anesthesiologist (MD) | Professional Fees | Professional Fee | |||
| 0964 | Anesthetist (CRNA) | Professional Fees | Professional Fee | |||
| 0969 | Other Professional Fee | Professional Fees | Professional Fee | |||
| 0970 | 097x: Professional Fees | RESERVED: Use 0960 for General Classification of Professional Fees | ||||
| 0971 | Laboratory | Professional Fees | Professional Fee | |||
| 0972 | Radiology - Diagnostic | Professional Fees | Professional Fee | |||
| 0973 | Radiology - Therapeutic | Professional Fees | Professional Fee | |||
| 0974 | Radiology - Nuclear Medicine | Professional Fees | Professional Fee | |||
| 0975 | Operating Room | Professional Fees | Professional Fee | |||
| 0976 | Respiratory Therapy | Professional Fees | Professional Fee | |||
| 0977 | Physical Therapy | Professional Fees | Professional Fee | |||
| 0978 | Occupational Therapy | Professional Fees | Professional Fee | |||
| 0979 | Speech Pathology | Professional Fees | Professional Fee | |||
| 0980 | 098x: Professional Fees | RESERVED: use 0960 for General Classification of Professional Fees | ||||
| 0981 | Emergency Room Services | Professional Fees | Professional Fee | |||
| 0982 | Outpatient Services | Professional Fees | Professional Fee | |||
| 0983 | Clinic | Professional Fees | Professional Fee | |||
| 0984 | Medical Social Services | Professional Fees | Professional Fee | |||
| 0985 | EKG | Professional Fees | Professional Fee | |||
| 0986 | EEG | Professional Fees | Professional Fee | |||
| 0987 | Hospital Visit | Professional Fees | Professional Fee | |||
| 0988 | Consultation | Professional Fees | Professional Fee | |||
| 0989 | Private Duty Nurse | Professional Fees | Professional Fee | |||
| 0990 | 099x: Patient Convenience Items | General Classification: Patient Convenience Items | Other Charges | Other; Other Not Including Nursery & NICU & Psych | ||
| 0991 | Cafeteria/Guest Tray | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0992 | Private Linen Service | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0993 | Telephone/Telecom | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0994 | TV/Radio | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0995 | Non-patient Room Rentals | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0996 | Late Discharge | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0997 | Admissions Kits | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0998 | Beauty Shop/Barber | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 0999 | Other Convenience Items | Other Charges | Other; Other Not Including Nursery & NICU & Psych | |||
| 1000 | 100x: Behavioral Health Accommodations | General Classification: Behavioral Health Accommodations | Behavioral Health | |||
| 1001 | Residential - Psychiatric | Behavioral Health | ||||
| 1002 | Residential - Chemical Dependency | Behavioral Health | ||||
| 1003 | Supervised Living | Behavioral Health | ||||
| 1004 | Halfway House | Behavioral Health | ||||
| 1005 | Group Home | Behavioral Health | ||||
| 1006 | Outdoor/Wilderness Behavioral Health | Behavioral Health | ||||
| 2100 | 210x: Alternative Therapy Services | General Classification: Alternative Therapy Services | ||||
| 2101 | Acupuncture | |||||
| 2102 | Acupressure | |||||
| 2103 | Massage | |||||
| 2104 | Reflexology | |||||
| 2105 | Biofeedback | |||||
| 2106 | Hypnosis | |||||
| 2109 | Other Alternative Therapy Service | |||||
| 3101 | 310x: Adult Care | Adult Day Care, Medical and Social - Hourly | ||||
| 3102 | Adult Day Care, Social - Hourly | |||||
| 3103 | Adult Day Care, Medical and Social - Daily | |||||
| 3104 | Adult Day Care, Social - Daily | |||||
| 3105 | Adult Foster Care - Daily | |||||
| 3109 | Other Adult Care |
