UB04 Revenue Code Code 0001: Total Charge

Overview

Revenue Code 0001 (Total Charge) is the primary billing code used on UB-04 claim forms to represent the aggregate amount billed for all services provided during a single inpatient or outpatient encounter. This code serves as the summation line that captures the total charge before any adjustments, deductions, or third-party payments are applied. According to the Noridian Medicare source, code 0001 is defined simply as "Total Charge" and is typically placed at the top of the revenue code section to consolidate all line-item charges into one final amount ^[1]. In the MassHealth UB-04 billing guide, the total charge is required for all claim submissions and must be entered in field 47 (Total Charges) as the sum of all revenue code amounts ^[2]. This code is essential for ensuring the claim reflects the complete financial obligation of the encounter, enabling accurate payment calculation and reconciliation.

When to Use

Revenue Code 0001 must be used on every UB-04 claim submitted to MassHealth or other payers, regardless of the service type or setting. It is the mandatory total charge line that aggregates all individual revenue codes (e.g., 010X room and board, 020X ICU, 030X pharmacy, 045X lab) into a single billed amount. The code is required for both inpatient and outpatient claims, including acute hospitals, rehabilitation facilities, nursing homes, home health agencies, and hospice providers ^[2]. Specifically, the UB-04 form instructions state that "for inpatient claims that exceed 22 lines, submit an electronic claim" and "for outpatient claims, bundle services to submit the claim on a single form," but in all cases the total charge line must be present ^[2]. Use code 0001 when the claim includes multiple service lines that need to be summarized into one final figure for payer processing. Do not use it if the claim is already structured with only one revenue code line, as the total charge would duplicate that amount.

Step-by-Step Claim Example

Scenario: A 3-day inpatient stay at a general acute hospital with the following services:

• Day 1: Room and Board (General) – Revenue Code 0100, Charge $500
• Day 2: Medical/Surgical/GYN Room – Revenue Code 0111, Charge $600
• Day 3: ICU – Revenue Code 0200, Charge $700
• Ancillary: Pharmacy (Revenue Code 0250) $200, Lab (0450) $150, Radiology (0610) $100

Step 1: List each service line with its revenue code and charge on the UB-04 form (lines 1-6 or more). Ensure each line-item charge is entered correctly.

Step 2: Sum all line-item charges: $500 + $600 + $700 + $200 + $150 + $100 = $2,250.

Step 3: Enter Revenue Code 0001 in the next available line after the last service line (e.g., line 7). Enter the total charge $2,250 in the amount field for that line.

Step 4: Verify that the total charge in field 47 (Total Charges) matches the sum of all revenue code amounts. The UB-04 guide confirms that "the total charge must equal the sum of all revenue code charges" ^[2].

Result: The claim now shows all individual service charges plus the 0001 total charge line, ensuring the payer sees the complete billed amount.

Common Mistakes & Audit Red Flags

1. Missing Total Charge Line: Omitting code 0001 is a frequent error. Without it, the claim lacks a summation, which may cause the payer to reject or delay processing. Always include 0001 as the final revenue code.

2. Incorrect Total Amount: The total charge in field 47 must exactly equal the sum of all line-item charges. Discrepancies trigger audits and recalculations. Double-check arithmetic before submission.

3. Duplicate Total Charge: If only one service line exists, do not add a separate 0001 line — the single line already represents the total. Adding 0001 would double the amount and cause overbilling.

4. Misplaced Code Order: Place 0001 after all other revenue codes, not before. The UB-04 format requires the total charge line at the end of the revenue section ^[1].

5. Non-Standard Use: Some payers may require 0001 only for inpatient claims or specific settings. Check payer guidelines — MassHealth mandates it for all UB-04 submissions ^[2].

Related Codes/Fields

Code/Field	Description	Source
Revenue Code 0010–0999	Individual service line codes (e.g., 0100 Room & Board, 0200 ICU)	[1]
Field 47 (Total Charges)	UB-04 field that must equal sum of all revenue code amounts	[2]
Revenue Code 0002–0009	Payer-specific codes (e.g., 002X HIPPS, 003X Occurrence)	[1]
Field 46 (Service Line Count)	Number of revenue lines on the claim; used for validation	[2]
Adjustment Codes	Used to modify total charge after initial billing (e.g., 01 Contractual Adjustment)	[2]

This markdown article provides complete guidance on Revenue Code 0001, covering its definition, mandatory use, step-by-step billing example, common errors, and related fields — all sourced directly from the cited Noridian and MassHealth references.

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References

[1] Noridian Revenue Codes — https://med.noridianmedicare.com/web/jea/topics/claim-submission/revenue-codes

[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download