LAC 40:I.2533
LAC 40:I.2533. Outpatient Revenue Codes Not Billable on the UB-92
Cite as La. Admin. Code tit. 40, pt. I, § 2533
A. The following revenue codes must be billed on the HCFA 1500 Form.
Revenue Code(s) | Description
274 | Medical/Surgical Supplies Prosthetics
277 | Medical/Surgical Supplies Take Home Oxygen
290 | Durable Medical Equipment (DME) General Classification
291 | DME-Rental
292 | DME-Purchase
299 | DME-Other Equipment
500-539 | Outpatient Services, Clinic, Free-Standing Clinic and Osteopathic Services
570-599 | Home Health Services
540-549 | Ambulance Services
550-559 | Skilled Nursing
820-859 | Dialysis Service
860-879 | Not Assigned
880-889 | Miscellaneous Dialysis Services
900-909 | Psychiatric/Psychological Treatments
910-919 | Psychiatric/Psychological Services
940-949 | Therapeutic Services
960-989 | Professional Fees