They are an important part of healthcare billing because they allow you to know what service was given to a patient. Out of these, Revenue Code 200 plays a special and important role for providers offering intensive care. This guide presents a full examination of Revenue Code 200, offering its definition, common uses, impact on billing and coding, and its role in healthcare reimbursement.
What Is Revenue Code 200?
Intensive Care – General is assigned the code 200 in the UB 04 (CMS-1450) claim form. These codes are used when services from a hospital’s ICU do not fall into the categories of the other narrowly defined ICU codes.
The terms used in invoicing are called:
Revenue Code 200 is Intensive Care Unit (ICU), General Classification
This code is generally used when someone in general intensive care does not require specialized care in a surgical, medical, or coronary unit (201, 202, or 210).
Primary Purpose of Revenue Code 200
Revenue Code 200 is used to precisely show the care given to a patient in a general intensive care unit. People in the ICU are very ill and must be watched closely, treated with advanced methods and cared for with intensive medicine. By providing this revenue code, providers clearly state what their services involved.
- The place where treatment took place (the ICU)
- The broad type of care involved, also known as non-specialty intensive care
- How much you use for incidents, this also influences how much the organization pays
When the code is used correctly, it helps you follow billing rules and get properly paid by the payer.
When Should Revenue Code 200 Be Used?
Revenue Code 200 applies to payments made for:
- The patient is put in a general, rather than a surgical, medical, or heart ICU.
- These services are not recorded in specific revenue bid codes (201, 202, 204).
- A unit on the facility’s premises is set up as general intensive care, and services are provided at the ICU level with continuous surveillance and appropriate life support.
Case in Real Life
Patients hospitalized with sepsis and treated in the general ICU, not the surgical or cardiac ICU, should require the use of Revenue Code 200.
Distinguishing Revenue Code 200 from Other ICU Codes
| Revenue Code | Description | Use Case |
| 200 | Intensive Care, General Classification | General ICU care without surgical or cardiac focus |
| 201 | Intensive Care, Surgical | Post-operative ICU care |
| 202 | Intensive Care, Medical | ICU care for non-surgical medical conditions |
| 203 | Intensive Care, Pediatric | ICU services for children |
| 204 | Intensive Care, Psychiatric | Psychiatric ICU admissions |
| 210 | Coronary Care, General Classification | Cardiac-specific ICU care |
The choice is made based on the type of unit, the patient’s main diagnosis, and how care was provided.
Billing Considerations for Revenue Code 200
When billing using Revenue Code 200, providers must consider several key elements to make sure claims process properly when faced with them.
1. The compatibility of ICD and CPT/HCPCS is necessary.
To receive reimbursement for revenue code 200, the description for service and the diagnosis or procedure (ICD-10 and CPT/HCPCS) must be the same. Code incorrectly, and your insurance claim may be rejected.
2. Documentation Requirements
ICU admission should be supported by clear, sufficient documentation.
- What led to ICU care
- How closely the situation is watched and responded to
How treatment changes the patient’s condition
- Notes for nursing and physicians
The use of this revenue code is validated by proper documentation, and this is very important when undergoing audits or payer reviews.
3. Reimbursement Implications
Treatment in the ICU is among the most expensive services a hospital provides. Revenue Code 200 stands for heavy resource usage that leads to:
Assigning Patients to Diagnosis-Related Groups
- Payment made by Medicare/Medicaid
- Payments made by private insurance
The right usage of Revenue Code 200 helps the provider get the money they deserve for their intense efforts.
Common Errors Associated with Revenue Code 200
Healthcare providers must avoid making the mistakes listed below when filing claims.
When there is a more specific code, such as surgical for 201 and cardiac for 210, use 200.
- Billing ICU services without evidence to back it up
- Including short hospitalization stays in the ICU to increase care metrics
Not changing codes when the patient is admitted or discharged from the ICU
Clinical staff, coders, and billers should collaborate and ensure they follow the special requirements of each payer.
Best Practices for Using Revenue Code 200
- Regularly instruct staff about how to use the right ICU revenue codes.
- Use EHR systems to mark patients who are in the general ICU for treatment.
- Schedule frequent checks of billing in your ICU.
- Keep yourself informed about the different rules for Medicare and commercial insurance.
- Establish communication between the departments of physicians, nurses, and billing.
They help the company avoid mistakes and maximize its revenue.
Medicare Guidelines and Revenue Code 200
Because ICU services come with a large price tag, Medicare examines them with extra interest. Medicare’s regulations state:
- Both ICD-10 and HCPCS codes are needed together with the designated Revenue Code 200.
- Papers must show that the patient truly needs ICU care.
- If you cannot justify ICU stay, you may be denied payment or audited.
Since Medicare makes a difference between an ICU and a step-down unit, making sure the unit name is clear is necessary.
Impact of Revenue Code 200 on Hospital Revenue Cycle
The correct use of Revenue Code 200 impacts multiple stages of the revenue cycle:
| Stage | Impact |
| Patient Admission | Determines the initial classification of services |
| Coding and Documentation | Supports accurate DRG assignment |
| Billing | Ensures correct use of UB-04 claim form |
| Reimbursement | Affects payment from Medicare, Medicaid, or private insurers |
| Audits and Compliance | Helps defend claims during payer audits or RAC reviews |
Revenue Code 200 is important for hospitals to receive fair compensation for intensive medical care.
Revenue Code 200 vs. Step-Down Care
Hospitals need to classify care correctly between the ICU and step-down units (intermediate care).
- This revenue code includes ICU care that involves machines for breathing, one nurse for every patient, or circumstances where a patient is in danger.
- Step-down care (using Revenue Code 213) has reduced supervision and employs less medical staff than other intensive forms.
Using Revenue Code 200 for services that should be billed in other categories may result in both payer refusal and possible audits.
Table: Revenue Code 200 Snapshot
| Element | Description |
| Revenue Code | 200 |
| Description | Intensive Care Unit – General Classification |
| Setting | General ICU (non-surgical, non-cardiac) |
| Common Pairing | CPT: 99291, ICD-10: R65.20 (severe sepsis), etc. |
| Payer Concern | High-cost service; requires strong documentation. |
| Reimbursement Impact | Influences DRG, cost report, and insurer payment |
Operational Challenges and Staffing Requirements in General Intensive Care Units
Revenue Code 200 helps identify the financial side of ICU costs and also reveals the difficulties in running an everyday ICU. General ICUs care for a wide variety of patients, such as those in respiratory distress or with several injuries at once, so they need all available medical support and intensive resources.
Any airline needs to have a supply of knowledgeable staff for operations to run well. General ICUs keep staff levels low, often having only one or two nurses for each patient, so round-the-clock care is possible. As a result of this staff model, operating costs rise, and they justify using Revenue Code 200 for billing. ICUs must feature progressive life-support tools, bedside medical testing, and medical specialists ready to offer help any time of day or night. Since these patients are seriously ill, the units require advanced medical care and must keep good records, which is why accurate Revenue Code 200 coding is required.
Conclusion
Code 200 from the Revenue Code is used to cover all types of general care given to patients in the intensive care unit. When this code is understood and used correctly, hospitals are sure to be paid the right amount and remain within regulatory guidelines. Regardless of the condition, providers have to remember to document the high level of care required when billing with Revenue Code 200. Using information incorrectly can result in audits, rejected payments, and lower profits, so both compliance and the financial health of the organization depend on correct use.
Frequently Asked Questions
What is Revenue Code 200 used for?
Revenue Code 200 is for reporting services given in a general intensive care unit (ICU). It covers ICU services that aren’t listed as surgical or cardiac.
How is Revenue Code 200 not the same as Revenue Code 201?
Revenue Code 200 includes care in a general ICU, but Revenue Code 201 is for surgical intensive care following operations. Patient condition and the designation of the ICU are what matter.
Is Revenue Code 200 considered for use in the pediatric ICU?
No. Revenue Code 203 should be used to bill for any pediatric intensive care services since it’s the code for care given to children in Intensive care units.
What documents should a healthcare provider have before charging Revenue Code 200?
Your essay should have the following:
- Admission orders by a physician to the ICU
- Nursing records and vital readings at all times
- Comprehensive updates explaining how serious the patient’s illness is
Examples of such treatments include putting a patient on a ventilator, using vasopressors, or using dialysis.
How does this Revenue Code shape the way providers are reimbursed?
It points to high use of medical resources, which can determine the patient’s DRG and the amount the hospital receives. Misusing this form can result in a claim getting rejected and the possibility of an audit.
Can services under Revenue Code 200 be paid for by Medicare?
If need for the service is documented by medical records, Medicare will reimburse for codes 200. Even so, since they involve high costs, people often investigate ICU services deeply.
Do hospitals use Revenue Code 200 in outpatient departments?
That is not true; Revenue Code 200 is mostly applied to hospital inpatients. Delivering ICU-level care at home or in a private doctor’s office is rarely possible.
What codes are normally used with Revenue Code 200?
Most often, codes such as 99291 (critical care, first hour) and 99292 (each 30 minutes after that) for the ICU are used together with Revenue Code 200.
