UB04 Revenue Code Code 0400: Other Imaging Services

Overview

Revenue Code 0400 (Other Imaging Services) is a general category code used on the UB-04 claim form to report imaging services that do not fall under more specific imaging subcategories. According to the Noridian Medicare revenue code listing, the 040X series covers "Other Imaging" services, with 0400 representing the general classification, while specific subcodes include 0401 (Diagnostic mammography), 0402 (Ultrasound), 0403 (Screening mammography), 0404 (PET), and 0409 (Other) ^[1]. This code is part of the broader revenue code structure used by institutional providers to identify the type of service rendered.

When to Use

The code serves as a catch-all for basic X-rays, CT scans, MRI studies, and other imaging modalities that do not fit into the designated subcategories.

Providers should use this code when the imaging service is not specifically defined elsewhere in the revenue code structure. For example, if a facility performs a standard chest X-ray or a CT scan of the abdomen without a more specific revenue code designation, 0400 would be appropriate. However, if the service is clearly a diagnostic mammogram, ultrasound, screening mammogram, or PET scan, the more specific subcodes (0401-0404) should be used instead ^[1]. The code is also appropriate for general imaging services provided in outpatient hospital settings, hospital-licensed health centers, and other institutional provider locations.

Step-by-Step Claim Example

Scenario: A patient receives a chest X-ray and a CT scan of the abdomen at an acute outpatient hospital. Neither service qualifies as mammography, ultrasound, or PET scan.

Step 1: Complete the UB-04 claim form header information, including patient demographics, provider information, and dates of service. Ensure the form is completed for the specific member receiving services ^[2].

Step 2: This code will cover both the chest X-ray and CT scan as they fall under "Other Imaging Services" without more specific subcode assignments ^[1].

Step 3:

Step 4:

Step 5:

Step 6:

Step 7: For example, if the chest X-ray costs $150 and the CT scan costs $1,200, enter $1,350.

Step 8: Complete remaining fields (48-50) as required, including non-covered charges and payer information.

Step 9: Ensure the claim does not exceed 22 revenue code lines. For outpatient claims, bundle services as needed to fit on a single form ^[2].

Common Mistakes & Audit Red Flags

Using 0400 when a specific subcode exists: The most common error is using 0400 for services that have dedicated revenue codes. For example, billing a screening mammogram under 0400 instead of 0403, or an ultrasound under 0400 instead of 0402, can trigger claim denials or audits ^[1].

Incorrect provider type usage: Revenue code 0400 is only valid for institutional providers (hospitals, clinics, etc.) and should not be used by professional providers who bill on CMS-1500 forms. The UB-04 is specifically for acute inpatient hospitals, acute outpatient hospitals, chronic disease hospitals, community health centers (home health only), home health agencies, hospice providers, and other institutional providers ^[2].

Exceeding line limits: Claims with more than 22 revenue code lines must be submitted electronically, not on paper UB-04 forms. For outpatient claims, services must be bundled to fit on a single form ^[2].

Missing HCPCS codes: Failing to include appropriate HCPCS codes in Field 44 for the imaging services can lead to claim rejection or payment delays. Each imaging service should have a corresponding HCPCS code to support the revenue code.

Duplicate billing: Billing the same imaging service under both 0400 and a more specific subcode (e.g., 0402 for ultrasound) can result in overpayment and audit flags. Ensure each service is billed under only one revenue code.

Related Codes/Fields

Code/Field	Description	Relationship to 0400
0401	Diagnostic mammography	Specific subcode under 040X; use instead of 0400 for diagnostic mammograms
0402	Ultrasound	Specific subcode under 040X; use instead of 0400 for ultrasound services
0403	Screening mammography	Specific subcode under 040X; use instead of 0400 for screening mammograms
0404	PET	Specific subcode under 040X; use instead of 0400 for PET scans
0409	Other Imaging Services	More specific "other" code; use when 0400 is too general
Field 42	Revenue Code	The field where 0400 is entered on the UB-04 form
Field 43	Description	Text field for describing the imaging service
Field 44	HCPCS/Rates	Required to specify the exact procedure performed
Field 45	Service Date	Date(s) of service for the imaging procedure
Field 46	Service Units	Number of units for each imaging service
Field 47	Total Charges	Total charges for the imaging services billed

^[1]
[2]

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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