Healthcare experts use revenue code 0022 to bill the services that involve high-level medical interventions, such as multiple diagnoses and prescription management. This code is part of the Health Insurance Prospective Payment System (HIPPS) and often varies based on the nature of medical decisions and the time spent on patient care.
This blog will explore crucial details about revenue code 0002, including its uses, benefits, and common mistakes to avoid during code assignment.
Call us Now
Understanding Revenue Code 0022
Revenue code 002, also known as rev code 0022, is used by the skilled nursing facility (SNF) to bill the services under medicare part A prospective payment system (PPS).
Contrary to other codes that represent individual services, rev code 0022 includes bundled services rendered under the SNF prospective payment system. Healthcare providers should submit it with the HIPPS code, reported in FL 44 of the UB-04 form.
This combination helps payers to determine the level of patient care and release accurate and timely payments.
Here is an example:
A patient is discharged after a Medicare inpatient stay.
The hospital needs to report the patient’s discharge status code on the claim.
To do this, the provider adds:
- Revenue Code: 0022
- Description: Discharge/Transfer Information
- Associated Value Code: e.g., Code 01 (Discharged to home)
- Usage: Helps Medicare process the correct DRG payment.
Following services are excluded when insurance is covered by Part A
- Physician professional services
- Certain dialysis-related services
- Certain ambulance services
- Chemotherapy drugs and administration services
- Radioisotope services
- Custom-designed prosthetic devices
Why Using Revenue Code 0022 Matters
Revenue Code 0022 directly impacts the practice revenue and is used to show the skilled nursing level of care offered by a provider during an inpatient stay. This code is important whenever your facility bills under a prospective payment system (PPS).
Providers use this code to:
- Describe the patient’s acuity level
- Show the intensity of nursing services rendered.
- Supports the payment group assigned to the inpatient stay.
- Ensure accurate case-mix classification.
Example:
A patient is admitted to a Skilled Nursing Facility after surgery and needs help with wound care, pain management, and daily monitoring. Since there is a need for higher level of skilled nursing care, the facility reports:
- Revenue Code: 0022
- RUG/PDPM Group: Displays the patient’s level of care
- Units: 1
- Charges: $0.00 (because payment is based on the PDPM system, not per-day charge)
By using Revenue Code 0022, the provider shows that this patient required skilled nursing services. This helps the system calculate the correct PPS payment for the stay.
Avoid Misusing Revenue Code 0022
Using Revenue Code 0022 incorrectly can lead to claim denials, delayed payments, or audits. If the patient did not receive skilled nursing care on a given day, reporting this code would be inaccurate and could cause compliance issues.
Example
A patient is only receiving basic monitoring or personal assistance without skilled nursing interventions. Reporting 0022 would be wrong because the skilled nursing level of care was not provided.
Revenue Code 002 Reimbursement Rates
Reimbursement under Revenue Code 0022 depends on the patient’s care category, acuity, and skilled-nursing intensity. In a prospective payment system (PPS), the code doesn’t itself set a flat dollar rate. Instead, it triggers the correct case-mix classification, which aligns with a payment group.
The group’s rate reflects daily service cost, nursing hours, patient complexity, and therapy minutes. Facilities must pair 0022 with a valid HIPPS code or classification code. If documentation supports higher nursing needs, the payment group may be higher and the facility receives fuller reimbursement reflecting more intensive skilled-nursing care.
How to Bill Revenue Code 0022 Correctly
Billing Revenue Code 0022 requires careful steps to ensure the claim is accepted and paid correctly. You must confirm that the patient received skilled nursing services, pair the code with the correct HIPPS code, and make sure your notes match the level of care billed.
Each covered day should have one unit reported, and the documentation must clearly support medical necessity, nursing intensity, and daily skilled tasks. Accurate coding helps avoid denials and keeps your facility’s reimbursement process smooth.
Key Steps to Follow:
- Verify the patient received skilled nursing care on the reported day.
- Pair Revenue Code 0022 with the correct HIPPS or classification code.
- Match documentation with the assigned care level and payment group.
- Report one unit per covered day and confirm all details on the UB-04.
Take the Next Step Toward Accurate Billing
Improve your reimbursement process by reviewing your coding workflow today. Make sure your team understands how to use Revenue Code 0022 correctly so every inpatient stay receives the payment it deserves.
Conclusion
Revenue Code 0022 may look simple, but it has a strong impact on how your facility gets paid for skilled nursing services. When providers understand how to use it correctly, they avoid denials, speed up payments, and strengthen compliance. Accurate 0022 reporting is a key part of protecting your revenue cycle.
If you want a stronger billing process, updated coding guides, or personalized help, our platform is built for providers like you. Paymedics billing experts fix errors early, submit cleaner claims, and improve your financial results.
Frequently asked Questions
What is Revenue Code 0022 used for?
It reports the skilled nursing level of care in inpatient billing and supports payment classification.
Do I need a HIPPS code with Revenue Code 0022
Yes, you must always pair it with the correct HIPPS or classification code.
Can incorrect 0022 reporting delay payments?
Yes, missing or incorrect details often lead to claim denials or payment delays.
What documentation is required?
Your notes must show skilled nursing tasks, medical necessity, and the patient’s response to care.
How often should Revenue Code 0022 be reported?
It should be reported for every covered inpatient day where skilled nursing care is provided, ensuring each day reflects the right level of service.
