Box 43 displays a description or standard abbreviation for the revenue code shown in Box 42 on the same line. This field is not required. Revenue code descriptions are commonly assigned by the payer when the claim file is accepted for processing.
Custom revenue code descriptions are stored in the Claim Form Service Name field in the service billing profile. However, this description is not included on the claim file by default and can only be added using a claim rule.
To manage the Revenue Code Description on the claim file,
- Go to Practice Admin > Services.
- Click on the service name.
- Choose the Billing Profiles tab.
- Click on the billing profile name to open the contents.
- Select to make a Baseline or Scheduled Change Set edit to the Claim Form Service Name.
- Enter the revenue code description, then click Save.
To create the Claim Form Rule for adding a service description on a UB04,
- Navigate to Management Center, then choose the Claim Rules tab.
- Click the "Create Claim Form Rule" button.
- Select the Practice.
- Name the claim rule.
- Set Claim Type to Institutional.
- Choose the conditions that must be met for the rule to apply.
- Select the Available Behavior: Claim Form Service Names, then click Add.
- From the Select: dropdown, choose Require and Write to Claim.
- Click the Create button.
For detailed steps on how to create a Claim Form Rule to ensure a description goes out with the revenue code on the claim file, check out Claim Rule: Claim Form Service Name.
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