UB04 Revenue Code Code 0820: Hemodialysis - Outpatient or Home

Overview

Revenue code 0820 is used to bill for hemodialysis services provided in an outpatient or home setting. According to the Noridian Medicare revenue code list, code 0820 falls under the 082X series labeled “Hemodialysis Outpatient/Home” with the description “0820 General.” ^[1] This is part of a broader dialysis category that includes outpatient and home hemodialysis, peritoneal dialysis (083X), CAPD (084X), CCPD (085X), and miscellaneous dialysis (088X). The MassHealth UB-04 billing guide confirms that the UB-04 claim form is used by providers such as acute outpatient hospitals, home health agencies, and hospice providers, all of which may deliver hemodialysis services. ^[2]

When to Use

Use revenue code 0820 when billing for general hemodialysis services that are performed in an outpatient department of a hospital, a hospital‑licensed health center, or in the patient’s home through a home health agency. The code is designated as the general code for the Hemodialysis Outpatient/Home category by Noridian, with sub‑codes 0821 through 0829 available for more specific types of hemodialysis (e.g., home hemodialysis training, self‑care dialysis). ^[1] The MassHealth UB-04 guide lists a number of provider types that must use the UB-04 form, including acute outpatient hospitals, chronic disease and rehabilitation outpatient hospitals, home health agencies, and hospice providers. ^[2] If the hemodialysis is provided in a setting that matches these provider types, code 0820 is the appropriate starting point for the revenue code line. Always verify payer‑specific requirements, as some payers may require one of the sub‑codes (0821–0829) rather than the general 0820.

Step‑by‑Step Claim Example

Assume a patient receives a home hemodialysis training session at an outpatient hospital clinic. The provider will submit a UB-04 claim with the following entries:

2. Field 44 – HCPCS/Rate Code: If a specific HCPCS code is applicable (e.g., G0311 for home hemodialysis training), enter it here. (Note: The provided sources do not list HCPCS codes; this step follows standard billing practice.)
3. Field 45 – Service Date: Enter the date of the hemodialysis session.
4. Field 48 – Non‑Covered Charges: Leave blank if the service is covered.
5. Field 49 – Page Number: Page 1 of 1.

The MassHealth UB-04 guide instructs that up to 22 revenue code lines may be entered on a single form; for outpatient claims, bundle related services to fit one form. ^[2] Ensure that the patient’s demographic and insurance information is completed accurately in Fields 1–13, and that the provider information (Fields 56–66) is correct.

Common Mistakes & Audit Red Flags

• Using the wrong sub‑code: Noridian lists 0820 as “General” and 0821–0829 as “Various” for more specific hemodialysis types. Applying 0820 when a payer requires a sub‑code (e.g., 0821 for home hemodialysis training) can lead to denial or down‑coding. ^[1]
• Mixing revenue codes from different dialysis categories: For example, using 0820 for peritoneal dialysis (which should be 083X) or CAPD (084X) is a common error. Each dialysis modality has its own series.
• Exceeding 22 revenue lines per claim: MassHealth states that up to 22 revenue codes and charges may be entered per UB-04. ^[2] Exceeding this limit on a paper claim will result in rejection; electronic submission is required for inpatient claims with more than 22 lines.
• Omitting required supporting codes: For home hemodialysis, payers may require a modifier or HCPCS code in Field 44 to indicate “home” setting. Failure to provide these can trigger an audit for medical necessity.
• Inconsistent provider type: The UB-04 must be used by eligible provider types as listed in the MassHealth guide (e.g., acute outpatient hospitals, home health agencies). ^[2] If a non‑eligible type submits a UB-04 with 0820, the claim will be rejected.

Related Codes/Fields

Revenue Code	Description	Source
0810 – 0819	Organ acquisition (general, living donor, cadaver donor, etc.)	[1]
0820	Hemodialysis Outpatient/Home – General	[1]
0821 – 0829	Hemodialysis Outpatient/Home – Various (specific types)	[1]
0830 – 0839	Peritoneal Dialysis Outpatient/Home	[1]
0840 – 0849	CAPD Outpatient/Home	[1]
0850 – 0859	CCPD Outpatient/Home	[1]
0880 – 0889	Miscellaneous Dialysis (ultrafiltration, home dialysis aid visit, etc.)	[1]

Related UB-04 fields:

• Field 42 – Revenue Code: Where code 0820 is entered. ^[2] (refers to revenue codes generally)
• Field 44 – HCPCS/Rate Code: May be required to specify the dialysis procedure or equipment.
• Field 47 – Total Charges: Amount billed for the line.
• Field 45 – Service Date: Date dialysis was performed.

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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