| TOTAL CHARGE |
0001
|
| UNDEFINED |
0002 - 0009
|
| RESERVED |
001X
|
| RESERVED |
002X - 006X
|
| RESERVED |
007X - 009X
|
| SPECIAL CHARGES |
022X
|
| GENERAL CLASSIFICATION |
SPECIAL CHARGES |
0220 |
| ADMISSION CHARGE |
ADMIT CHARGE |
0221 |
| TECHNICAL SUPPORT CHARGE |
TECH SUPPORT CHG |
0222 |
| U. R. SERVICE CHARGE |
UR CHARGE |
0223 |
| LATE CHARGE, MEDICALLY NECESSARY |
LATE DISCH/MED NEC |
0224 |
| OTHER SPECIAL CHARGES |
OTHER SPEC CHG |
0229
|
| INCREMENTAL NURSING CHARGE RATE |
023X
|
| GENERAL CLASSIFICATION |
NURSING INCREM |
0230 |
| NURSERY |
NUR INCR/NURSERY |
0231 |
| OB (INCLUDING GYNECOLOGICAL) |
NUR INCR/OB-GY |
0232 |
| ICU |
NUR INCR/ICU |
0233 |
| CCU |
NUR INCR/CCU |
0234 |
| HOSPICE |
NUR INCR/HOSPICE |
0235 |
| OTHER |
NUR INCR/OTHER |
0239
|
ALL INCLUSIVE ANCILLARY
|
024X
|
| GENERAL CLASSIFICATION |
ALL INCL ANCIL |
0240 |
| OTHER INCLUSIVE ANCILLARY |
ALL INCL ANCIL/OTHER |
0249
|
(Effective through 9/31/1999)
|
ALL INCLUSIVE ANCILLARY
|
024X
|
| GENERAL CLASSIFICATION |
ALL INCL ANCIL |
0240 |
| BASIC |
ALL INCL BASIC |
0241 |
| COMPREHENSIVE |
ALL INCL COMP |
0242 |
| SPECIALTY |
ALL INCL SPECIAL |
0243 |
| OTHER INCLUSIVE ANCILLARY |
ALL INCL ANCIL/OTHER |
0249
|
(Effective 10/1/1999)
|
PHARMACY
|
025X
|
| GENERAL CLASSIFICATION |
PHARMACY |
0250 |
| GENERIC DRUGS |
DRUGS/GENERIC |
0251 |
| NON-GENERIC DRUGS |
DRUGS/NONGENERIC |
0252 |
| TAKE HOME DRUGS |
DRUGS/TAKEHOME |
0253 |
| DRUGS INCIDENT TO OTHER DIAGNOSTIC SERVICES |
DRUGS/INCIDNT OTHER DX |
0254 |
| DRUGS INCIDENT TO RADIOLOGY |
DRUGS/INCIDENT RAD |
0255 |
| EXPERIMENTAL DRUGS |
DRUGS/EXPERIMT |
0256 |
| NON-PRESCRIPTION |
DRUGS/NONSCRPT |
0257 |
| IV SOLUTIONS |
IV SOLUTIONS |
0258 |
| OTHER PHARMACY |
DRUGS/OTHER |
0259
|
INTRAVENOUS THERAPY
|
026X
|
| IV THERAPY |
0260 |
| INFUSION PUMP |
IV THER/INFSN PUMP |
0261 |
| IV THERAPY/PHARMACY SERVICES |
IV THER/PHARM/SVC |
0262 |
| IV THERAPY/DRUG/SUPPLY DELIVERY |
IV THER/DRUG/SUPPLY DELV |
0263 |
| IV THERAPY/SUPPLIES |
IV THER/SUPPLIES |
0264 |
| OTHER IV THERAPY |
IV THERAPY/OTHER |
0269
|
MEDICAL/SURGICAL SUPPLIES AND DEVICES (ALSO SEE 62X, AN EXTENSION OF 27X)
|
027X
|
| GENERAL CLASSIFICATION |
MED-SUR SUPPLIES |
0270 |
| NON STERILE SUPPLY |
NON-STER SUPPLY |
0271 |
| STERILE SUPPLY |
STERILE SUPPLY |
0272 |
| TAKE HOME SUPPLIES |
TAKEHOME SUPPLY |
0273 |
| PROSTHETIC/ORTHOTIC DEVICES |
PROSTH/ORTH DEV |
0274 |
| PACE MAKER |
PACE MAKER |
0275 |
| INTRAOCULAR LENS |
INTRA OC LENS |
0276 |
| OXYGEN - TAKE HOME |
O2/TAKEHOME |
0277 |
| OTHER IMPLANTS |
SUPPLY/IMPLANTS |
0278 |
| OTHER SUPPLIES/DEVICES |
SUPPLY/OTHER |
0279
|
ONCOLOGY
|
028X
|
| GENERAL CLASSIFICATION |
ONCOLOGY/OTHER |
0280 |
| OTHER ONCOLOGY |
ONCOLOGY/OTHER |
0289
|
DURABLE MEDICAL EQUIPMENT (OTHER THAN RENAL)
|
029X
|
| GENERAL CLASSIFICATION |
MED EQUIP/DURAB |
0290 |
| RENTAL |
MED EQUIP/RENT |
0291 |
| PURCHASE OF NEW DME |
MED EQUIP/NEW |
0292 |
| PURCHASE OF USED DME |
MED EQUIP/USED |
0293 |
| SUPPLIES/DRUGS FOR DME EFFECTIVENESS |
MED EQUIP/SUPPLIES/DRUGS |
0294 |
| - (HOME HEALTH AGENCY ONLY) |
| OTHER EQUIPMENT |
MED EQUIP/OTHR |
0299
|
LABORATORY
|
030X
|
| GENERAL CLASSIFICATION |
LABORATORY OR LAB |
0300 |
| CHEMISTRY |
LAB/CHEMISTRY |
0301 |
| IMMUNOLOGY |
LAB/IMMUNOLOGY |
0302 |
| RENAL PATIENT (HOME) |
LAB/RENAL HOME |
0303 |
| NON-ROUTINE DIALYSIS |
LAB/NR DIALYSIS |
0304 |
| HEMATOLOGY |
LAB/HEMATOLOGY |
0305 |
| BACTERIOLOGY AND MICROBIOLOGY |
LAB/BACT-MICRO |
0306 |
| UROLOGY |
LAB/UROLOGY |
0307 |
| OTHER LABORATORY |
LAB/OTHER |
0309
|
LABORATORY - PATHOLOGICAL
|
031X
|
| GENERAL CLASSIFICATION |
PATHOLOGY LAB OR PATH LAB |
0310 |
| CYTOLOGY |
PATHOL/CYTOLOGY |
0311 |
| HISTOLOGY |
PATHOL/HYSTOL |
0312 |
| BIOPSY |
PATHOL/BIOPSY |
0314 |
| OTHER |
PATHOL/OTHER |
0319
|
RADIOLOGY - DIAGNOSTIC
|
032X
|
| GENERAL CLASSIFICATION |
DX X-RAY |
0320 |
| ANGIOCARDIOGRAPHY |
DX X-RAY/ANGIO |
0321 |
| ARTHROGRAPHY |
DX X-RAY/ARTH |
0322 |
| ARTERIOGRAPHY |
DX X-RAY/ARTER |
0323 |
| CHEST X-RAY |
DX X-RAY/CHEST |
0324 |
| OTHER |
DX X-RAY/OTHER |
0329
|
RADIOLOGY - THERAPEUTIC
|
033X
|
| GENERAL CLASSIFICATION |
RX X-RAY |
0330 |
| CHEMOTHERAPY - INJECTED |
CHEMOTHER/INJ |
0331 |
| CHEMOTHERAPY - ORAL |
CHEMOTHER/ORAL |
0332 |
| RADIATION THERAPY |
RADIATION RX |
0333 |
| CHEMOTHERAPY - IV |
CHEMOTHERP-IV |
0335 |
| OTHER |
RX X-RAY/OTHER |
0339
|
NUCLEAR MEDICINE
|
034X
|
| GENERAL CLASSIFICATION |
NUCLEAR MEDICINE OR NUC MED |
0340 |
| DIAGNOSTIC |
NUC MED/DX |
0341 |
| THERAPEUTIC |
NUC MED/RX |
0342 |
| DIAGNOSTIC RADIOPHARMACEUTICALS |
NUC MED/DX-RADIOPHARM |
0343 |
| THERAPEUTIC RADIOPHARMACEUTICALS |
NUC MED/RX-RADIOPHARM |
0344 |
| OTHER |
NUC MED/OTHER |
0349
|
C.A.T. SCAN
|
035X
|
| GENERAL CLASSIFICATION |
CT SCAN |
0350 |
| HEAD SCAN |
CT SCAN/HEAD |
0351 |
| BODY SCAN |
CT SCAN/BODY |
0352 |
| OTHER CT SCANS |
CT SCAN/OTHER |
0359
|
OPERATING ROOM SERVICES
|
036X
|
| GENERAL CLASSIFICATION |
OR SERVICES |
0360 |
| MINOR SURGERY |
OR MINOR |
0361 |
| ORGAN TRANSPLANT - OTHER THAN KIDNEY |
OR/ORGAN TRANS |
0362 |
| KIDNEY TRANSPLANT |
OR/KIDNEY TRANS |
0367 |
| OTHER OPERATING ROOM SERVICES |
OR/OTHER |
0369
|
ANESTHESIOLOGY
|
037X
|
| GENERAL CLASSIFICATION |
ANESTHESIA |
0370 |
| ANESTHESIA INCIDENT TO RADIOLOGY |
ANESTHE/INCIDENT RAD |
0371 |
| ANESTHESIA INCIDENT TO OTHER DIAGNOSTIC SERVICES |
ANESTHE/INCDNT OTHER DX |
0372 |
| ACUPUNCTURE |
ANESTHE/ACUPUNC |
0374 |
| OTHER ANESTHESIA |
ANESTHE/OTHER |
0379
|
BLOOD
|
038X
|
| GENERAL CLASSIFICATION |
BLOOD |
0380 |
| PACKED RED CELLS |
BLOOD/PKD RED |
0381 |
| WHOLE BLOOD |
BLOOD/WHOLE |
0382 |
| PLASMA |
BLOOD/PLASMA |
0383 |
| PLATELETS |
BLOOD/PLATELETS |
0384 |
| LEUCOCYTES |
BLOOD/LEUCOCYTES |
0385 |
| OTHER COMPONENTS |
BLOOD/COMPONENTS |
0386 |
| OTHER DERIVATIVES (CRYOPRICIPITATES) |
BLOOD/DERIVATIVES |
0387 |
| OTHER BLOOD |
BLOOD/OTHER |
0389
|
BLOOD STORING & PROCESSING
|
039X
|
| GENERAL CLASSIFICATION |
BLOOD/STOR-PROC |
0390 |
| BLOOD ADMINISTRATION |
BLOOD/ADMIN |
0391 |
| BLOOD PROCESSING AND STORAGE |
BLOOD/STORAGE |
0392 |
| OTHER BLOOD HANDLING |
BLOOD/ADMIN/STOR/OTHER |
0399
|
OTHER IMAGING SERVICES
|
040X
|
| GENERAL CLASSIFICATION |
IMAGE SERVICE |
0400 |
| DIAGNOSTIC MAMMOGRAPHY |
DIAG MAMMOGRAPHY |
0401 |
| ULTRASOUND |
ULTRASOUND |
0402 |
| SCREENING MAMMOGRAPHY |
SCRN MAMMOGRAPHY |
0403 |
| POSITRON EMISSION TOMOGRAPHY |
PET SCAN |
0404 |
| OTHER IMAGING SERVICES |
OTHER IMAG SVS |
0409
|
RESPIRATORY THERAPY
|
041X
|
| GENERAL CLASSIFICATION |
RESPIRATORY SVC |
0410 |
| INHALATION SERVICES |
INHALATION SVC |
0412 |
| HYPERBARIC OXYGEN THERAPY |
HYPERBARIC O2 |
0413 |
| OTHER RESPIRATORY SERVICES |
OTHER PRESPIR SVS |
0419
|
PHYSICAL THERAPY
|
042X
|
| GENERAL CLASSIFICATION |
PHYSICAL THERP |
0420 |
| VISIT CHARGE |
PHYS THERP/VISIT |
0421 |
| HOURLY CHARGE |
PHYS THERP/HOUR |
0422 |
| GROUP RATE |
PHYS THERP/GROUP |
0423 |
| EVALUATION OR RE-EVALUATION |
PHYS THERP/EVAL |
0424 |
| OTHER PHYSICAL THERAPY |
OTHER PHYS THERP |
0429
|
OCCUPATIONAL THERAPY
|
043X
|
| GENERAL CLASSIFICATION |
OCCUPATIONAL THER |
0430 |
| VISIT CHARGE |
OCCUP THERP/VISIT |
0431 |
| HOURLY CHARGE |
OCCUP THERP/HOUR |
0432 |
| GROUP RATE |
OCCUP THERP/GROUP |
0433 |
| EVALUATION OR RE-EVALUATION |
OCCUP THERP/EVAL |
0434 |
| OTHER OCCUPATIONAL THERAPY |
OTHER OCCUP THERP |
0439
|
SPEECH-LANGUAGE PATHOLOGY
|
044X
|
| GENERAL CLASSIFICATION |
SPEECH PATHOL |
0440 |
| VISIT CHARGE |
SPEECH PATH/VISIT |
0441 |
| HOURLY CHARGE |
SPEECH PATH/HOUR |
0442 |
| GROUP RATE |
SPEECH PATH/GROUP |
0443 |
| EVALUATION OR RE-EVALUATION |
SPEECH PATH/EVAL |
0444 |
| OTHER SPEECH-LANGUAGE PATHOLOGY |
OTHER SPEECH PAT |
0449
|
EMERGENCY ROOM SERVICES
|
045X
|
| GENERAL CLASSIFICATION |
EMERG ROOM |
0450 |
| EMTALA EMERGENCY MEDICAL SCREENING SERVICE |
ER/EMTALA |
0451 |
| (Effective 4/1/1996) |
| ER BEYOND EMTALA SCREENING (Effective 4/1/1996) |
ER/BEYOND EMTALA |
0452 |
| URGENT CARE (Effective 10/1/1995) |
URGENT CARE |
0456 |
| OTHER EMERGENCY ROOM |
OTHER EMERG ROOM |
0459
|
PULMONARY FUNCTION
|
046X
|
| GENERAL CLASSIFICATION |
PULMONARY FUNC |
0460 |
| OTHER PULMONARY FUNCTION |
OTHER PULMON FUNC |
0469
|
AUDIOLOGY
|
047X
|
| GENERAL CLASSIFICATION |
AUDIOLOGY |
0470 |
| DIAGNOSTIC |
AUDIOLOGY/DX |
0471 |
| TREATMENT |
AUDIOLOGY/RX |
0472 |
| OTHER AUDIOLOGY |
OTHER AUDIOL |
0479
|
CARDIOLOGY
|
048X
|
| GENERAL CLASSIFICAITON |
CARDIOLOGY |
0480 |
| CARDIAC CATH LAB |
CARDIAC CATH LAB |
0481 |
| STRESS TEST |
STRESS TEST |
0482 |
| ECHOCARDIOLOGY |
ECHOCARDIOLOGY |
0483 |
| OTHER CARDIOLOGY |
OTHER CARDIOL |
0489
|
AMBULATORY SURGICAL CARE
|
049X
|
| GENERAL CLASSIFICATION |
AMBUL SURG |
0490 |
| OTHER AMBULATORY SURGICAL CARE |
OTHER AMBL SURG |
0499
|
OUTPATIENT SERVICES
|
050X
|
| GENERAL CLASSIFICATION |
OUTPATIENT SVS |
0500 |
| OTHER OUTPATIENT SERVICES |
OUTPATIENT/OTHER |
0509
|
CLINIC
|
051X
|
| GENERAL CLASSIFICATION |
CLINIC |
0510 |
| CHRONIC PAIN CENTER |
CHRONIC PAIN CL |
0511 |
| DENTAL CLINIC |
DENTAL CLINIC |
0512 |
| PSYCHIATRIC CLINIC |
PSYCH CLINIC |
0513 |
| OB-GYN CLINIC |
OB-GYN CLINIC |
0514 |
| PEDIATRIC CLINIC |
PEDS CLINIC |
0515 |
| URGENT CARE CLINIC (Effective 10/1/1995) |
URGENT CLINIC |
0516 |
| FAMILY CLINIC (Effective 10/1/1995) |
FAMILY CLINIC |
0517 |
| OTHER CLINIC |
OTHER CLINIC |
0519
|
FREE-STANDING CLINIC
|
052X
|
| GENERAL CLASSIFICATION |
FREESTAND CLINIC |
0520 |
| RURAL HEALTH - CLINIC/FQHC |
FS-RURAL/CLINIC |
0521 |
| RURAL HEALTH - HOME |
FS-RURAL/HOME |
0522 |
| FAMILY PRACTICE |
FS-FAMILY PRACTICE |
0523 |
| FAMILY CLINIC |
FR/STD FAMILY CLINIC |
0524 |
| URGENT CARE CLINIC (Effective 10/1/1996) |
FR/STD URGENT CLINIC |
0526 |
| OTHER FREESTANDING CLINIC |
OTHER FR-CLINIC |
0529
|
OSTEOPATHIC SERVICES
|
053X
|
| GENERAL CLASSIFICATION |
OSTEOPATH SVS |
0530 |
| OSTEOPATHIC THERAPY |
OSTEOPATH RX |
0531 |
| OTHER OSTEOPATHIC SERVICES |
OTHER OSTEOPATH |
0539
|
AMBULANCE SERVICE
|
054X
|
| GENERAL CLASSIFICATION |
AMBULANCE |
0540 |
| SUPPLIES |
AMBUL/SUPPLY |
0541 |
| MEDICAL TRANSPORT |
AMBUL/MED TRANS |
0542 |
| HEART MOBILE |
AMBUL/HEARTMOBL |
0543 |
| OXYGEN |
AMBUL/OXY |
0544 |
| AIR AMBULANCE |
AIR AMBULANCE |
0545 |
| NEONATAL AMBULANCE SERVICES |
AMBUL/NEONAT |
0546 |
| PHARMACY |
AMBUL/PHARMACY |
0547 |
| TELEPHONE TRANSMISSION EKG |
AMBUL/TELEPHONIC EKG |
0548 |
| OTHER AMBULANCE |
OTHER AMBULANCE |
0549
|
SKILLED NURSING
|
055X
|
| GENERAL CLASSIFICATION |
SKILLED NURSING |
0550 |
| VISIT CHARGE |
SKILLED NURS/VISIT |
0551 |
| HOURLY CHARGE |
SKILLED NURS/HOUR |
0552 |
| OTHER SKILLED NURSING |
SKILLED NURS/OTHER |
0559
|
MEDICAL SOCIAL SERVICES
|
056X
|
| GENERAL CLASSIFICATION |
MED SOCIAL SVS |
0560 |
| VISIT CHARGE |
MED SOC SERVS/VISIT |
0561 |
| HOURLY CHARGE |
MED SOC SERV/HOUR |
0562 |
| OTHER MEDICAL SOCIAL SERVICES |
MED SOC SERV/OTHER |
0569
|
HOME HEALTH AID
|
057X
|
| GENERAL CLASSIFICATION |
AID/HOME HEALTH |
0570 |
| VISIT CHARGE |
AIDE/HOME HLTH/VISIT |
0571 |
| HOURLY CHARGE |
AIDE/HOME HLTH/HOUR |
0572 |
| OTHER HOME HEALTH AIDE |
AIDE/HOME HLTH/OTHER |
0579
|
HOME HEALTH- - OTHER VISITS
|
058X
|
| GENERAL CLASSIFICATION |
HH-OTH VIS |
0580 |
| VISIT CHARGE |
HH-OTH VIS/VISIT |
0581 |
| HOURLY CHARGE |
HH-OTH VIS/HOUR |
0582 |
| ASSESSMENT |
HH-OTH VIS/ASSESS |
0583 |
| OTHER HOME HEALTH VISITS |
HH-OTH VIS/OTHER |
0589
|
(Effective 2/2/2007)
|
UNITS OF SERVICE (HOME HEALTH)
|
059X
|
| GENERAL CLASSIFICATION |
UNIT/HOME HEALTH |
0590 |
| HOME HEALTH OTHER UNITS (NUBC RESERVED effective 3/1/2007) |
UNIT/HOME HLTH/OTHER |
0599
|
OXYGEN (HOME HEALTH)
|
060X
|
| GENERAL CLASSIFICATION |
O2/HOME HEALTH |
0600 |
| OXYGEN - STATE/EQUIP/SUPPL OR CONT |
O2/STAT EQUIP/SUPPL/CONT |
0601 |
| OXYGEN - STATE/EQUIP/SUPPL/UNDER 1 LPM |
O2/STAT EQUIP/UNDER 1 LPM |
0602 |
| OXYGEN - STATE/EQUIP/OVER 4 LPM |
O2/STAT EQUIP/OVER 4 LPM |
0603 |
| OXYGEN - PORTABLE ADD-ON |
O2/PORTABLE ADD-ON |
0604 |
| OTHER OXYGEN |
O2 - OTHER |
0609
|
MRI
|
061X
|
| GENERAL CLASSIFICATION |
MRI |
0610 |
| BRAIN (INCLUDING BRAINSTEM) |
MRI - BRAIN |
0611 |
| SPINAL CORD (INCLUDING SPINE) |
MRI - SPINE |
0612 |
| OTHER MRI |
MRI - OTHER |
0619
|
(Effective through 9/30/1998)
|
MAGNETIC RESONANCE TECHNOLOGY
|
061X
|
| GENERAL CLASSIFICATION |
MRT |
0610 |
| MRI - BRAIN (INCLUDING BRAINSTEM) |
MRI - BRAIN |
0611 |
| MRI - SPINAL CORD (INCLUDING SPINE) |
MRI - SPINE |
0612 |
| RESERVED |
|
0613 |
| MRI - OTHER |
MRI - OTHER |
0614 |
| MRA - HEAD AND NECK |
MRA - HEAD AND NECK |
0615 |
| MRA - LOWER EXTREMITIES |
MRA - LOWER EXT |
0616 |
| RESERVED |
|
0617 |
| MRA - OTHER |
MRA - OTHER |
0618 |
| OTHER MRT |
MRT - OTHER |
0619
|
(Effective 10/1/1998)
|
MEDICAL/SURGICAL SUPPLIES - EXTENSION OF 27X
|
062X
|
| SUPPLIES INCIDENT TO RADIOLOGY |
MED-SUP SUP/INCDNT RAD |
0621 |
| SUPPLIES INCIDENT TO OTHER DIAGNOSTIC SERVICES |
MED-SUR SUP/INCDNT ODX |
0622 |
| SURGICAL DRESSINGS (Effective 1/1/1995) |
MED-SUR SUP/DRESS |
0623 |
| FDA INVESTIGATIONAL DEVICES (Effective 10/1/1996) |
FDA INVEST DEVICE |
0624
|
DRUGS REQUIRING SPECIFIC IDENTIFICATION
|
063X
|
| GENERAL CLASSIFICATION (NUBC RESERVED effective 3/1/2007) |
DRUGS |
0630 |
| SINGLE SOURCE DRUG |
DRUG/SINGLE |
0631 |
| MULTIPLE SOURCE DRUG |
DRUG/MULT |
0632 |
| RESTRICTIVE PRESCRIPTION |
DRUG/RSTR |
0633 |
| ERYTHROPOIETIN (EPO) LESS THAN 10,000 UNITS |
DRUG/EPO<10,000 UNITS |
0634 |
| ERYTHROPOIETIN (EPO) 10,000 UNITS OR MORE |
DRUG/EPO=>10,000 UNITS |
0635 |
| DRUGS REQUIRING DETAILED CODING |
DRUGS/DETAIL CODE |
0636 |
| SELF-ADMINISTRABLE DRUGS (Effective 10/1/1997) |
DRUGS/SELF ADMIN |
0637
|
HOME IV THERAPY SERVICES
|
064X
|
| GENERAL CLASSIFICATION |
IV THERAPY SVC |
0640 |
| NONROUTINE NURSING, CENTRAL LINE |
NON RT NURSING/CENTRAL |
0641 |
| IV SITE CARE, CENTRAL LINE (SEE NOTE) |
IV SITE CARE/CENTRAL |
0642 |
| IV START/CHANGE, PERIPHERAL LINE |
IV STRT/CHNG/PERIPHAL |
0643 |
| NONROUTINE NURSING, PERIPHERAL LINE |
NONRT NURSING/PERIPHRL |
0644 |
| TRAINING PATIENT/CAREGIVER, CENTRAL LINE |
TRNG PT/CAREGVR/CENTRAL |
0645 |
| TRAINING, DISABLED PATIENT, CENTRAL LINE |
TRNG DSBLPT/CENTRAL |
0646 |
| TRAINING, PATIENT/CAREGIVER, PERIPHERAL LINE |
TRNG/PT/CARGVR/PERIPHRL |
0647 |
| TRAINING, DISABLED PATIENT PERIPHERAL LINE |
TRNG/DSBLPAT/PERIPHRL |
0648 |
| OTHER IV THERAPY SERVICES |
OTHER IV THERAPY SVC |
0649
|
HOSPICE SERVICE
|
065X
|
| GENERAL CLASSIFICATION |
HOSPICE |
0650 |
| ROUTINE HOME CARE |
HOSPICE/RTN HOME |
0651 |
| CONTINUOUS HOME CARE |
HOSPICE CTNS HOME |
0652 |
| RESERVED |
|
0653 |
| RESERVED |
|
0654 |
| INPATIENT RESPITE CARE |
HOSPICE/IP RESPITE |
0655 |
| GENERAL INPATIENT CARE (NON-RESPITE) |
HOSPICE/IP NON-RESPITE |
0656 |
| PHYSICIAN SERVICES |
HOSPICE/PHYSICIAN |
0657 |
| OTHER HOSPICE |
HOSPICE/OTHER |
0659
|
RESPITE CARE (HHA ONLY)
|
066X
|
| GENERAL CLASSIFICATION |
RESPITE CARE |
0660 |
| HOURLY CHARGE/SKILLED NURSING |
RESPITE/SKILLED NURSE |
0661 |
| HOURLY CHARGE/HOME HEALTH AIDE/HOMEMAKER |
RESPITE/HMEAID/HMEMKR |
0662
|
(Effective through 03/31/2003)
|
RESPITE CARE
|
066X
|
| GENERAL CLASSIFICATION |
RESPITE CARE |
0660 |
| HOURLY CHARGE/NURSING |
RESPITE/NURSE |
0661 |
| HOURLY CHARGE/AIDE/HOMEMAKER/COMPANION |
RESPITE/AID/HMEMKR/COMP |
0662 |
| DAILY RESPITE CHARGE |
RESPITE DAILY |
0663 |
| OTHER RESPITE CARE |
RESPITE OTHER |
0669
|
(Effective 4/1/2003)
|
NOT ASSIGNED (Effective through 9/30/1996)
|
067X
|
OUTPATIENT SPECIAL RESIDENANCE CHARGES (Effective 10/1/1996)
|
067X
|
| GENERAL CLASSIFICATION |
OP SPEC RES |
0670 |
| HOSPITAL BASED |
OP SPEC RES/HOSP BASED |
0671 |
| CONTRACTED |
OP SPEC RES/CONTRACTED |
0672 |
| OTHER SPECIAL RESIDENCE CHARGES |
OP SPEC RES/OTHER |
0679
|
TRAUMA RESPONSE
|
068X
|
| NOT USED |
|
0680 |
| LEVEL I |
TRAUMA LEVEL I |
0681 |
| LEVEL II |
TRAUMA LEVEL II |
0682 |
| LEVEL III |
TRAUMA LEVEL III |
0683 |
| LEVEL IV |
TRAUMA LEVEL IV |
0684 |
| OTHER TRAUMA RESPONSE |
TRAUMA OTHER |
0689
|
(Effective 10/1/2002)
|
NOT ASSIGNED
|
069X
|
CAST ROOM
|
070X
|
| GENERAL CLASSIFICATION |
CAST ROOM |
0700 |
| OTHER CAST ROOM (NUBC RESERVED effective 3/1/2007) |
OTHER CAST ROOM |
0709
|
RECOVERY ROOM
|
071X
|
| GENERAL CLASSIFICATION |
RECOVERY ROOM |
0710 |
| OTHER RECOVERY ROOMROOM (NUBC RESERVED effective 3/1/2007) |
OTHER RECOV RM |
0719
|
DELIVERY ROOM AND LABOR ROOM
|
072X
|
| GENERAL CLASSIFICATION |
DELIVERY ROOM/LABOR |
0720 |
| LABOR |
LABOR |
0721 |
| DELIVERY |
DELIVERY ROOM |
0722 |
| CIRCUMCISION |
CIRCUMCISION |
0723 |
| BIRTHING CENTER |
BIRTHING CENTER |
0724 |
| OTHER LABOR ROOM/DELIVERY |
OTHER/DELIV-LABOR |
0729
|
EKG/ECG (ELECTROCARDIOGRAM)
|
073X
|
| GENERAL CLASSIFICATION |
EKG/ECG |
0730 |
| HOLTER MONITOR |
HOLTER MONT |
0731 |
| TELEMETRY |
TELEMETRY |
0732 |
| OTHER EKG/ECG |
OTHER EKG-ECG |
0739
|
EEG (ELECTROENCEPHALOGRAPHY)
|
074X
|
| GENERAL CLASSIFICATION |
EEG |
0740 |
| OTHER EEG (NUBC RESERVED effective 3/1/2007) |
OTHER EEG |
0749
|
GASTRO-INTESTINAL SERVICE
|
075X
|
| GENERAL CLASSIFICATION |
GASTR-INST SVS |
0750 |
| OTHER GASTRO-INTESTINAL (NUBC RESERVED effective 3/1/2007) |
OTHER GASTRO-INTS |
0759
|
TREATMENT OR OBSERVATION ROOM
|
076X
|
| GENERAL CLASSIFICATION |
TREATMENT/OBSERVATION RM |
0760 |
| TREATMENT ROOM |
TREATMENT RM |
0761 |
| OBSERVATION ROOM |
OBSERVATION RM |
0762 |
| OTHER TREATMENT/OBSERVATION ROOM |
OTHER TREAT/OBSERV RM |
0769
|
NOT ASSIGNED (Effective through 9/30/1994)
|
077X
|
PREVENTIVE CARE SERVICES (Effective 10/1/1994)
|
077X
|
| GENERAL CLASSIFICATION |
PREVENT CARE SVS |
0770 |
| VACCINE ADMINISTRATION |
TREATMENT RM |
0771 |
| OTHER (NUBC RESERVED effective 3/1/2007) |
OTHER PREVENT |
0779
|
NOT ASSIGNED (Effective through 9/30/1996)
|
078X
|
TELEMEDICINE SERVICES (Effective 10/1/1996)
|
078X
|
| GENERAL CLASSIFICATION |
TELEMEDICINE |
0780 |
| TELEMEDICINE OTHER (NUBC RESERVED effective 3/1/2007) |
TELEMEDICINE/OTHER |
0789
|
LITHOTRIPSY
|
079X
|
| GENERAL CLASSIFICATION |
LITHOTRIPSY |
0790 |
| OTHER LITHOTRIPSY (NUBC RESERVED effective 3/1/2007) |
LITHOTRIPSY/OTHER |
0799
|
INPATIENT RENAL DIALYSIS
|
080X
|
| GENERAL CLASSIFICATION |
RENAL DIALYSIS |
0800 |
| HEMODIALYSIS (INPATIENT) |
DIALY/INPT |
0801 |
| PERITONEAL DIALYSIS INPATIENT (NON-CAPD) |
DIALY/INP/PER |
0802 |
| CONTINUOUS AMBULATORY PERITONEAL DIALYSIS - (CAPD) INPATIENT |
DIALY/INPT/CAPD |
0803 |
| CONTINUOUS CYCLING PERITONEAL DIALYSIS - (CAPD) INPATIENT |
DIALY/INPT/CCPD |
0804 |
| OTHER INPATIENT DIALYSIS |
DIALY/INPT/OTHER |
0809
|
ACQUISITION OF BODY COMPONENTS (Effective 3/1/2007)
|
081X
|
| GENERAL CLASSIFICATION |
ORGAN ACQUIST |
0810 |
| LIVING DONOR - KIDNEY |
KIDNEY/LIVE |
0811 |
| CADAVER DONOR - KIDNEY |
KIDNEY/CADAVER |
0812 |
| UNKNOWN DONOR - KIDNEY |
KIDNEY/UNKNOWN |
0813 |
| OTHER KIDNEY ACQUISITION |
KIDNEY/OTHER |
0814 |
| CADAVER DONOR - HEART |
HEART/CADAVER |
0815 |
| OTHER HEART ACQUISITION |
HEART/OTHER |
0816 |
| DONOR-LIVER |
LIVER ACQUISIT |
0817 |
| OTHER ORGAN ACQUISITION |
ORGAN/OTHER |
0819
|
Acquisition of Body Components
|
081X
|
| GENERAL CLASSIFICATION |
ORGAN ACQUIST |
0810 |
| LIVING DONOR |
LIVING DONOR |
0811 |
| CADAVER DONOR |
CADAVER DONOR |
0812 |
| UNKNOWN DONOR |
UNKNOWN DONOR |
0813 |
| UNSUCCESSFUL ORGAN SEARCH |
UNSUCCESSFUL SEARCH |
0814 |
| - DONOR BANK CHANGES (Effective 10/1/1994) |
| OTHER |
OTHER DONOR |
0819
|
HEMODIALYSIS - OUTPATIENT OR HOME
|
082X
|
| GENERAL CLASSIFICATION |
HEMO/OP OR HOME |
0820 |
| HEMODIALYSIS/COMPOSITE OR OTHER RATE |
HEMO/COMPOSITE |
0821 |
| HOME SUPPLIES |
HEMO/HOME/SUPPL |
0822 |
| HOME EQUIPMENT |
HEMO/HOME/EQUIP |
0823 |
| MAINTENANCE 100% |
HEMO/HOME/100% |
0824 |
| SUPPORT SERVICES |
HEMO/HOME/SUPSERV |
0825 |
| OTHER OUTPATIENT HEMODIALYSIS |
HEMO/HOME/OTHER |
0829
|
PERITONEAL DIALYSIS - OUTPATIENT OR HOME
|
083X
|
| GENERAL CLASSIFICATION |
PERITONEAL/OP OR HOME |
0830 |
| PERITONEAL/COMPOSITE OR OTHER RATE |
PERTNL/COMPOSITE |
0831 |
| HOME SUPPLIES |
PERTNL/HOME/SUPPL |
0832 |
| HOME EQUIPMENT |
PERTNL/HOME/EQUIP |
0833 |
| MAINTENANCE 100% |
PERTNL/HOME/100% |
0834 |
| SUPPORT SERVICES |
PERTNL/HOME/SUPSERV |
0835 |
| OTHER OUTPATIENT PERITONEAL DIALYSIS |
PERTNL/HOME/OTHER |
0839
|
CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) - OUTPATIENT OR HOME
|
084X
|
| GENERAL CLASSIFICATION |
CAPD/OP OR HOME |
0840 |
| CAPD/COMPOSITE OR OTHER RATE |
CAPD/COMPOSITE |
0841 |
| HOME SUPPLIES |
CAPD/HOME/SUPPL |
0842 |
| HOME EQUIPMENT |
CAPD/HOME/EQUIP |
0843 |
| MAINTENANCE 100% |
CAPD/HOME/100% |
0844 |
| SUPPORT SERVICES |
CAPD/HOME/SUPSERV |
0845 |
| OTHER OUTPATIENT CAPD |
CAPD/HOME/OTHER |
0849
|
CONTINUOUS CYCLING PERITONEAL DIALYSIS (CCPD) - OUTPATIENT OR HOME
|
085X
|
| GENERAL CLASSIFICATION |
CCPD/OP OR HOME |
0850 |
| CCPP/COMPOSITE OR OTHER RATE |
CCPD/COMPOSITE |
0851 |
| HOME SUPPLIES |
CCPD/HOME/SUPPL |
0852 |
| HOME EQUIPMENT |
CCPD/HOME EQUIP |
0853 |
| MAINTENANCE 100% |
CCPD/HOME/100% |
0854 |
| SUPPORT SERVICES |
CCPD/HOME/SUPSERV |
0855 |
| OTHER OUTPATIENT CCPD |
CCPD/HOME/OTHER |
0859
|
RESERVED FOR DIALYSIS (NUBC RESERVED effective 3/1/2007)
|
086X
|
RESERVED FOR DIALYSIS (NUBC RESERVED effective 3/1/2007)
|
087X
|
MISCELLANEOUS DIALYSIS
|
088X
|
| GENERAL CLASSIFICATION |
DIALY/MISC |
0880 |
| ULTRAFILTRATION |
DIALY/ULTRAFILT |
0881 |
| HOME DIALYSIS AID VISIT |
HOME DIALYSIS AID VISIT |
0882 |
| MISCELLANEOUS DIALYSIS OTHER |
DIALY/MISC/OTHER |
0889
|
OTHER DONOR BANK (NUBC RESERVED effective 3/1/2007)
|
089X
|
| GENERAL CLASSIFICATION |
DONOR BANK |
0890 |
| BONE |
DONOR BANK/BONE |
0891 |
| ORGAN (OTHER THAN KIDNEY) |
DONOR BANK/ORGN |
0892 |
| SKIN |
DONOR BANK/SKIN |
0893 |
| OTHER DONOR BANK |
OTHER DONOR BANK |
0899
|
PSYCHIATRIC/PSYCHOLOGICAL TREATMENTS (BEHAVIORAL HEALTH TREATMENTS/SERVICES)
|
090X
|
| GENERAL CLASSIFICATION |
PSYCH TREATMENT |
0900 |
| ELECTROSHOCK TREATMENT |
ELECTRO SHOCK |
0901 |
| MILIEU THERAPY |
MILIEU THERAPY |
0902 |
| PLAY THERAPY |
PLAY THERAPY |
0903 |
| ACTIVITY THERAPY (Effective 4/1/1994) |
ACTIVITY THERAPY |
0904 |
| INTENSIVE OUTPATIENT SERVICES-PSYCHIATRIC |
BH/INTENS OP/PSYCH |
0905 |
| INTENSIVE OUTPATIENT SERVICES-CHEMICAL DEPENDENCY |
BH-INTENS OP/CHEM DEP |
0906 |
| COMMUNITY BEHAVIORAL HEALTH PROGRAM |
BH/COMMUNITY |
0907 |
| OTHER (NUBC RESERVED effective 3/1/2007) |
OTHER PSYCH RX |
0909
|
PSYCHIATRIC/PSYCHOLOGICAL SERVICES
|
091X
|
| GENERAL CLASSIFICATION (NUBC RESERVED effective 3/1/2007) |
PSYCH SERVICES |
0910 |
| REHABILITATION |
PSYCH/REHAB |
0911 |
| PARTIAL HOSPITALIZATION - LESS INTENSIVE (Effective 4/1/97) |
PSYCH/PARTIAL HOSP |
0912 |
| PARTIAL HOSPITALIZATION - INTENSIVE (Effective 4/1/97) |
PSYCH/PARTIAL INTENSIVE |
0913 |
| INDIVIDUAL THERAPY |
PSYCH/INDIV RX |
0914 |
| GROUP THERAPY |
PSYCH/GROUP RX |
0915 |
| FAMILY THERAPY |
PSYCH/FAMILY RX |
0916 |
| BIO FEEDBACK |
PSYCH/BIOFEED |
0917 |
| TESTING |
PSYCH/RESTING |
0918 |
| OTHER |
PSYCH/OTHER |
0919
|
OTHER DIAGNOSTIC SERVICES
|
092X
|
| GENERAL CLASSIFICATION |
OTHER DX SVS |
0920 |
| PERIPHERAL VASCULAR LAB |
PERI VASCUL LAB |
0921 |
| ELECTROMYELGRAM |
EMG |
0922 |
| PAP SMEAR |
PAP SMEAR |
0923 |
| ALLERGY TEST |
ALLERGY TEST |
0924 |
| PREGNANCY TEST |
PREG TEST |
0925 |
| OTHER DIAGNOSTIC SERVICE |
ADDITIONAL DX SVS |
0929
|
MEDICAL REHABILITATION DAY PROGRAM
|
093X
|
| HALF DAY |
HALF DAY |
0931 |
| FULL DAY |
FULL DAY |
0932
|
(Effective 4/1/2001)
|
OTHER THERAPEUTIC SERVICES
|
094X
|
| GENERAL CLASSIFICATION |
OTHER RX SVS |
0940 |
| RECREATIONAL THERAPY |
RECREATION RX |
0941 |
| EDUCATION/TRAINING |
EDUC/TRAINING |
0942 |
| CARDIAC REHABILITATION |
CARDIAC REHAB |
0943 |
| DRUG REHABILITATION |
DRUG REHAB |
0944 |
| ALCOHOL REHABILITATION |
ALCOHOL REHAB |
0945 |
| COMPLEX MEDICAL EQUIPMENT - ROUTINE |
CMPLX MED EQUIP-ROUT |
0946 |
| COMPLEX MEDICAL EQUIPMENT - ANCILLARY |
CMPLX MED EQUIP-ANC |
0947 |
| PULMONARY REHABILITATION (effective 10/1/2007) |
PULMONARY REHAB |
0948 |
| OTHER THERAPEUTIC SERVICES |
ADDITIONAL RX SVS |
0949
|
OTHER THERAPEUTIC SERVICES - EXTENSION OF 94X
|
095X
|
| RESERVED |
|
0950 |
| ATHLETIC TRAINING |
ATHLETIC TRAINING |
0951 |
| KINESIOTHERAPY |
KINESIOTHERAPY |
0952
|
(Effective 10/1/2000)
|
PROFESSIONAL FEES (ALSO SEE 97X & 98X)
|
096X
|
| GENERAL CLASSIFICATION |
PRO FEE |
0960 |
| PSYCHIATRIC |
PRO FEE/PSYCH |
0961 |
| OPHTHALMOLOGY |
PRO FEE/EYE |
0962 |
| ANESTHESIOLOGIST (MD) |
PRO FEE/ANES MD |
0963 |
| ANESTHETIST (CRNA) |
PRO FEE/ANES CRNA |
0964 |
| OTHER PROFESSIONAL FEES |
OTHER PRO FEE |
0969
|
PROFESSIONAL FEES (EXTENSION OF 96X)
|
097X
|
| LABORATORY |
PRO FEE/LAB |
0971 |
| RADIOLOGY- DIAGNOSTIC |
PRO FEE/RAD/DX |
0972 |
| RADIOLOGY - THERAPEUTIC |
PRO FEE/RAD/RX |
0973 |
| RADIOLOGY - NUCLEAR MEDICINE |
PRO FEE/ANES MD |
0974 |
| OPERATING ROOM |
PRO FEE/OR |
0975 |
| RESPIRATORY THERAPY |
PRO FEE/RESPIR |
0976 |
| PHYSICAL THERAPY |
PRO FEE/PHYSI |
0977 |
| OCCUPATIONAL THERAPY |
PRO FEE/OCCUPA |
0978 |
| SPEECH THERAPY |
PRO FEE/SPEECH |
0979
|
PROFESSIONAL FEES (EXTENSION OF 96X & 97X)
|
098X
|
| EMERGENCY ROOM |
PRO FEE/ER |
0981 |
| OUTPATIENT SERVICES |
PRO FEE/OUTPT |
0982 |
| CLINIC |
PRO FEE/CLINIC |
0983 |
| MEDICAL SOCIAL SERVICES |
PRO FEE/SOC SVC |
0984 |
| EKG |
PRO FEE/EKG |
0985 |
| EEG |
PRO FEE/EEG |
0986 |
| HOSPITAL VISIT |
PRO FEE/HOS VIS |
0987 |
| CONSULTATION |
PRO FEE CONSULT |
0988 |
| PRIVATE DUTY NURSE |
FEE/PVT NURSE |
0989
|
PATIENT CONVENIENCE ITEMS
|
099X
|
| GENERAL CLASSIFICATION |
PT CONVENIENCE |
0990 |
| CAFETERIA/GUEST TRAY |
CAFETERIA |
0991 |
| PRIVATE LINEN SERVICE |
LINEN |
0992 |
| TELEPHONE/TELEGRAPH |
TELEPHONE |
0993 |
| TV/RADIO |
TV/RADIO |
0994 |
| NONPATIENT ROOM RENTALS |
NONPT ROOM RENT |
0995 |
| LATE DISCHARGE CHARGE |
LATE DISCHARGE |
0996 |
| ADMISSION KITS |
ADMIT KITS |
0997 |
| BEAUTY SHOP/BARBER |
BARBER/BEAUTY |
0998 |
| OTHER PATIENT CONVENIENCE ITEMS |
PT CONVENCE/OTH |
0999
|
RESERVED FOR NATIONAL ASSIGNMENT
|
101X to 209X
|
ALTERNATE THERAPY SERVICES
Charges for therapies not elsewhere categoriezed under other therapeutic service revenue codes (042X, 043X, 044X, 091X, 094X, 095X) or services such as anesthesia or clinic (0374, 0511).
|
210X
|
| GENERAL CLASSIFICATION |
ALTTHERAPY |
2100 |
| ACUPUNCTURE |
ACUPUNCTURE |
2101 |
| ACUPRESSURE |
ACUPRESSURE |
2102 |
| MASSAGE |
MASSAGE |
2103 |
| REFLEXOLOGY |
REFLEXOLOGY |
2104 |
| BIOFEEDBACK |
BIOFEEDBACK |
2105 |
| HYPNOSIS |
HYPNOSIS |
2106 |
| OTHER ALTERNATIVE THERAPY SERVICES |
OTHER ALTTHERAPY |
2109
|
(Effective 4/1/2003)
|
RESERVED FOR NATIONAL ASSIGNMENT
|
211X to 309X
|
ADULT CARE
|
310X
|
| NUBC RESERVED (effective 3/1/2007) |
|
3100 |
| ADULT DAY CARE, MEDICAL AND SOCIAL - HOURLY |
ADULT MED/SOC HR |
3101 |
| ADULT DAY CARE SOCIAL - HOURLY |
ADULT SOC HR |
3102 |
| ADULT DAY CARE, MEDICAL AND SOCIAL - DAILY |
ADULT MED/SOC DAY |
3103 |
| ADULT DAY CARE, SOCIAL - DAILY |
ADULT SOC DAY |
3104 |
| ADULT FOSTER CARE - DAILY |
ADULT FOSTER DAY |
3105 |
| OTHER ADULT CARE |
OTHER ADULT |
3109
|
(Effective 4/1/2003)
|
RESERVED FOR NATIONAL ASSIGNMENT
|
311X to 999X
|
| Revised 3/2007 |