Is Revenue Code 551 a Tax or Medical Billing Code?
This guide clarifies the correct professional context for Revenue Code 551, detailing its function in billing and its distinction from federal tax systems.
Revenue codes are a classification system used to categorize services or goods for billing and tracking. These numeric codes provide a uniform method for organizations to report services rendered to payers. This system streamlines the billing process by creating a common language understood by both the provider and the payer, ensuring claims are processed efficiently.
Scope of Revenue Code 551 in Medical Billing
In healthcare, Revenue Code 551 is a specific identifier used for medical billing. It designates a “Skilled Nursing – Visit Charge” on a claim submitted to an insurance payer. This code signifies that a patient received medical services performed by or under the direct supervision of a licensed or registered nurse. These services are distinct from routine care and require the expertise of a trained nursing professional.
This code is a standard line item on the UB-04 claim form, the uniform institutional billing form used by hospitals, skilled nursing facilities, and other providers. When a facility bills an insurance company, Revenue Code 551 informs the payer that a skilled nursing visit occurred. It is often used with Current Procedural Terminology (CPT) codes, which detail the specific procedures performed during the visit, creating a comprehensive picture for reimbursement.
Insurance payers, including Medicare and private companies, use this code to process claims according to the patient’s benefits and the provider’s contract. The code also helps differentiate between levels of nursing care, such as visits by a Registered Nurse (RN) versus a Licensed Practical Nurse (LPN), which can have different reimbursement rates.
Clarification Regarding the Internal Revenue Code
The term “Revenue Code” can be confused with the United States tax system, but Revenue Code 551 has no connection to the Internal Revenue Code (IRC). The IRC is the body of federal tax law in the U.S. The term “Revenue Code” in this context is specific to healthcare billing and is established by the National Uniform Billing Committee (NUBC), not the Internal Revenue Service (IRS).
The structure of the IRC is different from the coding system used in medical billing. Federal tax laws are organized into “Sections,” not four-digit revenue codes. For example, deductions for business expenses are found under IRC Section 162, and depreciation is addressed in Section 179. These sections are part of the legal framework administered by the IRS for collecting federal taxes.
Searching for Revenue Code 551 in tax law publications or on the IRS website will not yield relevant results. The code is exclusively a billing tool for healthcare providers to categorize and claim payment for skilled nursing services, entirely separate from an individual’s or a business’s tax obligations.