NextGen Knowledge Center

Set Up Revenue Codes for Roll-Up Billing

Roll-up payers that are billed on UB/837I claims require a four-digit Revenue Code in Field Locator 42 for each line item on the claim. Therefore, a Revenue Code must be attached to all SIM codes in the Service Items Library that may be billed on a UB/837I claim.

To set up a revenue code for roll-up billing, do the following:

  1. Access File Maintenance.
  2. Select System Master Files, then PM, and then Revenue Codes.
    The Revenue Codes List window opens.
  3. Do one of the following:
    • To add a revenue code, select Open Menu and select New.
    • To modify a revenue code, select the code from the list, and then select Open Menu and select Open.
    The Add/Modify Revenue Code Informationwindow opens.
    Add Revenue Code Information

  4. In the Code field, enter the four-digit revenue code. This field is required.
  5. In the Description field, enter a descriptive name for the revenue code. This field is required.
  6. The Occurrence Code field is optional and can be left blank. It is needed only if the payer requires an Occurrence Code for the revenue code in Field Locators 31 – 36 on UB/837I claims. If selected, the code also defaults to the Encounter Maintenance window on the UB tab on the Occurrence Codes sub-tab in NextGen® Enterprise PM.
  7. The Value Code field is optional and can be left blank. It is needed only if the payer requires a value code for the revenue code in Field Locators 39 – 41 on UB/837I claims. If selected, the code also defaults to the Value Codes sub-tab on the UB tab of the Encounter Maintenance window in NextGen® Enterprise PM.
  8. In the Note field, enter any additional free-text notes for the revenue code. This field is not used anywhere else in the system and is for informational purposes only.
  9. To save changes and close the window, select OK.