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Wiki Revenue code to cpt/hcpcs code combination denials

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LeslieRae

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How would I explain to a provider why 0361 is not the correct revenue code for cpt 36216?
 
Revenue code 0361 is not necessarily incorrect for the procedure, but the particular payer may be looking for 0360 or a different code, depending on your provider's contract and the payer's requirements.

Revenue code assignments aren't really part of correct coding - these are dictated more by payer contracts and policies and by the National Uniform Billing Committee standards. If you're dealing with these types of questions, I'd recommend getting familiar with your payers' policies and also getting a subscription to the UB-04 manual which you can find here: https://www.nubc.org/subscription-information
 
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