What Is a Medical Revenue Code?

Revenue codes are unique three-digit numbers that are used in hospital billing and are reported to insurance companies on medical claims. Revenue codes tell the insurance company either which department the procedure was performed in or what was used for treatment. All revenue codes must accompany a valid procedure code.

Function

• There are multiple procedures that are performed in a hospital. The revenue code tells an insurance company whether the procedure was performed in the emergency room, operating room or another department. If the revenue code is attached to a supply code, it identifies whether the equipment was sterile or if the patient took it home.

Effects

• Revenue codes affect how an insurance company processes a claim and how the facility bills the claim.

Considerations

• Trained billers and coders use reference books to code claims. There are many revenue codes to choose from, and they rely on documentation in a patient's chart to determine which revenue and procedure codes accurately reflect what services a patient had.