CMS Required 4-Digit Revenue Code Format

Date: 02/19/21

Provider Communication

The AzCH team just received confirmation that effective January 1, 2021, in order to align with CMS guidance, a 4-digit Revenue code is required when billing a UB-04 claim. If a 4-digit code is not submitted, i.e. the leading 0 is dropped, the claim is rejecting.

​ACTION NEEDED

Please adopt the CMS guidance and bill with the 4-digit revenue code.

Example:

1. If claim is submitted with revenue code 0022, it will be accepted
2. If the leading 0 is dropped and the claim is submitted as 022, the claim will reject

Rejected claims will result in a claim reject letter with the following Error ID and Error Description:

Error ID	Error Description
34	Invalid Proc = Invalid Procedure

Below are links to the CMS guidance related to revenue code format:

• https://med.noridianmedicare.com/web/jea/topics/claim-submission/revenue-codes
• https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/r1875a3.pdf

Please share this information with your billing team and your clearinghouse!

 

PROVIDER TRAINING AND EDUCATION

Additional details and provider training opportunities are available to you at any time. Please email AzCHProviderEngagement@azcompletehealth.com.

THANK YOU for the amazing care you provide to our members!