NUBC Announces Updated Guidance on Revenue Code 42 Effective Immediately

On its October 18, 2023, the NUBC voted to amend the note on p. 123 of the 2024 UB-04 Manual by addition and deletion as follows:

The HCPCS usage notations in the revenue code section (FL 42) are provided for general guidance only; they do not represent hard and fast rules. Actual application may vary depending on certain circumstances.

The HCPCS usage notations in the revenue code section (FL 42) are intended to inform billing practices as follows:

For revenue codes with no guidance, i.e. blank, in the HCPCS Y/N column but a payer requires a HCPCS code, the payer should identify the appropriate HCPCS code(s) to report.

For revenue codes with guidance in the HCPCS Y/N column of ‘N’, a HCPCS code should not be required.

For revenue codes with guidance in the HCPCS Y/N column of ‘Y,’ the provider should report the appropriate HCPCS code(s).

If a provider chooses to report a HCPCS code for revenue codes with no guidance, i.e. blank, or guidance of “N” in the HCPCS Y/N column, a provider is permitted to do so.

This change is effective immediately and will be reflected in the 2025 UB-04 Manual.