CIP.003.245

REVENUE-CODE

Data Element

DE Number

CIP245

System DE Number

CIP.003.245

File Name

CIP - CLAIM INPATIENT

File Segment Number

CIP00003

File Segment Name

CLAIM-LINE-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code which identifies a specific accommodation, ancillary service or billing calculation (as defined by UB-04 Billing Manual). Revenue Code should be passed through to T-MSIS exactly as it was billed by the provider on the provider's 837I or UB-04 claim. It is only required on Inpatient, Long-Term Care and Other Fee for Service claims and managed care encounters that have a valid Type of Bill value. It's not required on financial transactions or non-institutional claims.
Size	X(4)
FLF Start Position	183
FLF Stop Position	186
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Revenue Code List (VVL) 2. When Source Location does not equal “23”, value requires an associated Revenue Charge 3. Value must be 4 characters or less 4. Mandatory

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

Revenue Code List

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-6901	If a claim line is a non-denied claim line from an IP file, then the revenue code value reported must be compatible with specified T-MSIS picture format: X(4).
RULE-792	If revenue code is populated on a non-denied claim line from an IP file, then the revenue code value reported must be in the list of valid values for revenue code.

Measure ID	Measure Name
MCR-3-015-12	% of claim headers with any accommodation revenue codes
MCR-3-018-15	Mean # Ancil. Codes on claims with Ancil. Codes
MCR-3-017-14	Mean # Accomm. Codes on claims with Accomm. Codes
MCR-1-017-15	Mean # Ancil. Codes on claims with Ancil. Codes
MCR-1-016-14	Mean # Accomm. Codes on claims with Accomm. Codes
FFS-3-018-15	Mean # Ancil. Codes on claims with Ancil. Codes
FFS-3-017-14	Mean # Accomm. Codes on claims with Accomm. Codes
FFS-1-018-27	Mean # Ancil. Codes on claims with Ancil. Codes
FFS-1-017-26	Mean # Accomm. Codes on claims with Accomm. Codes
ALL-13-003-3	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services
MIS-80-012-12	% missing: REVENUE-CODE (CIP00003)
MIS-22-013-13	% missing: REVENUE-CODE (CIP00003)
MIS-3-012-12	% missing: REVENUE-CODE (CIP00003)
MCR-3-018-21	Average # ancillary codes on claims with ancillary codes
MCR-3-017-20	Average # accommodation codes on claims with accommodation codes
MCR-3-016-13	% of claim headers with any ancillary revenue codes
ALL-13-003-5	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related
MCR-14-023-1	% of outpatient department claim lines that have accommodation codes
MCR-1-017-21	Average # ancillary codes on claims with ancillary codes
MCR-1-016-20	Average # accommodation codes on claims with accommodation codes
MCR-1-015-13	% of claim headers with any ancillary revenue codes
MCR-1-014-12	% of claim headers with any accommodation revenue codes
MCR-10-023-1	% of outpatient department claim lines that have accommodation codes
FFS-3-018-21	Average # ancillary codes on claims with ancillary codes
FFS-3-017-20	Average # accommodation codes on claims with accommodation codes
FFS-3-016-13	% of claim headers with any ancillary revenue codes
FFS-3-015-12	% of claim headers with any accommodation revenue codes
FFS-1-018-33	Average # ancillary codes on claims with ancillary codes
FFS-1-017-32	Average # accommodation codes on claims with accommodation codes
FFS-1-016-25	% of claim headers with any ancillary revenue codes
FFS-1-015-24	% of claim headers with any accommodation revenue codes

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT198	CLT.003.198	REVENUE-CODE	CLT00003	CLAIM-LINE-RECORD-LT
COT168	COT.003.168	REVENUE-CODE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CIP.003.245	UPDATE	Coding requirement	1. Value must be in Revenue Code List (VVL)2. A Revenue Code value requires an associated Revenue Charge3. Value must be 4 characters or less4. Mandatory	1. Value must be in Revenue Code List (VVL)2. When Source Location does not equal “23”, value requires an associated Revenue Charge3. Value must be 4 characters or less4. Mandatory
08/15/2023	3.12.0	CIP.003.245	UPDATE	Coding requirement	1. Value must be in Revenue Code List (VVL)2. A Revenue Code (CE) value requires an associated Revenue Charge (CE)3. Value must be 4 characters or less4. Mandatory	1. Value must be in Revenue Code List (VVL)2. A Revenue Code value requires an associated Revenue Charge3. Value must be 4 characters or less4. Mandatory