What Is Revenue Code 278 in Medical Billing?
Learn about Revenue Code 278, a critical medical billing standard for categorizing and processing claims for specific implantable devices.
Healthcare providers utilize a standardized system of numerical codes, known as revenue codes, to categorize services, supplies, and procedures furnished to patients. These codes are fundamental for ensuring accurate financial transactions between healthcare facilities and insurance companies. Their consistent application facilitates clear communication for proper billing and reimbursement.
General Role of Revenue Codes
Revenue codes are three or four-digit numbers primarily used on the UB-04 claim form, also known as the CMS-1450 form, for institutional billing. These codes classify the type of service or department that delivered care, such as room and board, laboratory services, or physical therapy. They allow facilities to group similar charges for billing.
The National Uniform Billing Committee (NUBC), formed by the American Hospital Association, maintains these universal codes to ensure consistency and standardization across the healthcare system. Revenue codes help insurance payers understand the service provided and determine if it aligns with patient benefits and coverage. Accurate use of these codes is crucial for compliance with billing regulations, particularly for Medicare and Medicaid claims, and helps prevent claim denials or payment delays. While revenue codes indicate the type or location of service, they often work in conjunction with more detailed procedure codes, such as Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, which describe the specific medical procedures performed.
Meaning of Revenue Code 278
Revenue Code 278 is a specific numerical identifier within the healthcare billing system for “Other Implantable Devices” on the UB-04 claim form. It signifies that the charges on a patient’s bill relate to a medical device implanted into the body.
This category encompasses devices surgically placed within a patient for therapeutic, diagnostic, or prosthetic purposes. The National Uniform Billing Committee defines an implantable device as objects or materials partially or totally inserted or grafted into the body. Importantly, for a device to be classified under this code, it must be intended to remain in the patient, distinguishing it from general medical supplies or instruments used during a procedure that are subsequently removed.
Application of Revenue Code 278
Healthcare providers use Revenue Code 278 when billing for specific types of medical devices that are permanently or semi-permanently implanted during a procedure. This code is applied to items surgically inserted into the body that remain with the patient upon discharge. Its inclusion on the UB-04 claim form signals to insurance companies that the billed charges are for an implantable item rather than a consumable supply.
Examples include stents, artificial joints, shunts, grafts, pins, plates, screws, and certain types of radioactive seeds. Pacemakers and intraocular lenses are often assigned their own specific revenue codes (275 and 276, respectively), but leads for pacemakers and defibrillators may fall under 278. When billing with Revenue Code 278, facilities must also include an appropriate HCPCS code that corresponds to the specific device. This detailed coding helps insurers accurately process claims by providing clear information about the type of implant used, which is critical for determining appropriate reimbursement for these specialized medical items.