Revenue Codes - Codes that identify the accommodations furnished, ancillary services
provided or billing calculation are entered in this field. The code indicates whether the
rate includes charges for ancillary services or only room and board.
If the patient was furnished more than one type of accommodation, the loops or lines for
each type of accommodation are completed. This is necessary whether or not the provider
charges an all-inclusive rate according to accommodations.
Where the all-inclusive rate varies with the type of accommodation, the Remarks field is
annotated for a five-or-more bed accommodation showing the reason for the
accommodation.
Unit of Service - A quantitative measure for services furnished, by revenue category, to or
for the patient which includes items such as the number of accommodation days, pints of
blood, or renal dialysis treatments, is entered.
Total Charges - The total charges pertaining to the related revenue code for the current
billing period is entered.
Noncovered Charges - The total non-covered charges pertaining to the related revenue
code for the current billing period is entered.
Ancillary Services
One All-Inclusive Charge Rate - Hospitals with one all-inclusive charge rate, including
ancillary services, are reflected in the revenue code. The total charge reflects the charge
for both accommodations and ancillary services.
Separate Ancillary All-Inclusive Rate - Some providers segregate charges for ancillary
services for billing purposes. Where a separate flat rate charge for ancillary services is
incurred either on a daily or total stay basis, the provider enters separate codes for the
services. These codes indicate whether the total charge includes only ancillary cost or
includes other costs (i.e., blood).
If applicable, the following additional billing instructions are applied:
• Blood
Whenever whole blood is furnished the patient, value codes and amounts are
completed. If the all-inclusive rate does not include the charge for whole blood or
packed cells, revenue codes, rates, service dates, units, and total charges are
completed in the same way a provider not using all-inclusive rates would complete
them. When the provider discounts its customary charges for unreplaced blood to
which the deductible is applicable, it shows the charges before the discount.
