N.Y. Comp. Codes R. & Regs. tit. 10 § 443.7

Current through Register Vol. 46, No. 50, December 11, 2024

Section 443.7 - Natural classification of revenue

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(a) The coding system for revenue provides for the use of six digits; four digits to the left of the decimal point and two digits to the right of the decimal point. In addition, for daily hospital service, ambulatory service and ancillary service revenue accounts only, positions seven and eight (third and fourth digits to the right of the decimal point) may be used for designating the program in which the patient is being served.

(b) Digit designations are as follows:

(1) First digit-indicates the primary account classification of the revenue account.

0-2 Not Used

3 Daily Hospital and Ambulatory Service Revenue

4 Ancillary Service Revenue

5 Other Operating Revenue and Deductions from Revenue

6-8 Not Used

9 Non-Operating Revenue

(2) Second through fourth digits (010-999)-indicate the primary subclassification of accounts.

(3) Decimal Point.

(4) Fifth digit-indicates the classification of service category of the patient service which the patient received.

.0 Inpatient - Acute Care

.1 Inpatient - Intensive Care

.2 Inpatient - Skilled Nursing Care

.3 Inpatient - Other

.4 Outpatient - Emergency

.5 Outpatient - Clinic

.6 Outpatient - Referred

.7 Home Health Care

.8 Day Care

.9 Non - Patient

(5) Sixth digit-indicates primary payor (admission status unless changed at later date) for patient as follows:

0 - Medicare - Part A

1 - Medicare - Part B

2 - Medicaid

3 - Other Government

4 - Workers' Compensation

5 - Blue Cross

6 - Commercial Insurance

7 - Charity/Uncompensated Care

8 - Self Pay

9 - Other

(6) Seventh and eighth digits-Used to designate program.

(7) Use of the sixth digit is unnecessary if logs are maintained.

(c) Examples of the coding of daily hospital and ancillary service revenue are as follows:

(1) A room and board charge made to a Pediatric Acute patient whose bill will be assumed by Blue Cross.

Daily Hospital Service Revenue

Pediatric Acute 1730..................................................................

Decimal Point .............................................................................

Inpatient Acute Care 0..................................................................

Blue Cross 5..................................................................................

Pediatric Acute Care 17...............................................................

or 3170.0517

(2) A laboratory charge (cytology) made to the same patient.

Ancillary Service Revenue 4.................................................................

Pathological Laboratory (Cytology) 231.................................................................

Decimal Point ..................................................................

Inpatient Acute Care 0.................................................................

Blue Cross 5.................................................................

Pediatric Acute Care 17.................................................................

or 4231.0517

(3) Digits seven and eight (e.g., 17) are optional digits indicating the program in which the patient is being served.

N.Y. Comp. Codes R. & Regs. Tit. 10 § 443.7