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We have noticed an increase in denied claims for facility-based outpatient services billed with certain revenue codes that require a CPT code for processing. Therefore, we encourage facility coders and billers to review Section 4 of the current South Carolina Department of Health and Human Services’ Hospital Services Provider Manual.
The revenue codes can be found on page 4-2 in the Reimbursement Type 4 schedule of the hospital manual. Services for these revenue codes that do not have a CPT code included will be denied. We would also recommend reviewing of the Revenue Codes section that begins on page 4-3. This chart identifies covered services by the indicators in the Covered Service column.
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