UB04 Field 43: Revenue Description

Overview

Field 43 (Revenue Description) on the UB-04 claim form is a 23‑character alphanumeric field that provides a textual description for each revenue code entered in Field 42. The description must match the standard revenue code definitions published by the National Uniform Billing Committee (NUBC).
For Medicare and many other payers, the description is taken from the list of revenue codes and their official titles found in the Noridian Revenue Codes reference. For example, revenue code 0124 must be described as “Room and Board Semi‑private – Psychiatric” and revenue code 0250 as “Pharmacy – General” ^[1].
The MassHealth UB-04 Guide states that up to 22 revenue lines (each consisting of a revenue code, description, and charge) may be entered on a single paper UB‑04 claim form ^[2]. While Field 43 is not explicitly called out in that guide, the requirement to include a description for each revenue code is implicit because the form’s layout includes this field.
Both inpatient and outpatient claims require a completed Revenue Description. The description helps payers verify that the billed revenue code is appropriate for the services rendered.

Why it matters: An accurate description in Field 43 supports correct claim adjudication and reduces the risk of denials or audits. Mismatched descriptions are a common cause of claim rejection.

When to Use

Field 43 must be completed for every revenue line on the UB‑04. Use it whenever you bill any of the revenue code categories listed in the Noridian Revenue Codes reference, including but not limited to:

• Room and Board (codes 011X–016X) – e.g., 0111 for “Medical/Surgical/GYN” private room
• Intensive Care (020X), Coronary Care (021X) – e.g., 0201 “Surgical ICU”
• Pharmacy (025X) – 0251 “Generic drugs”, 0252 “Non‑generic drugs”
• Laboratory (030X–031X) – 0305 “Hematology”, 0311 “Cytology”
• Radiology (032X–035X) – 0324 “Chest X‑ray”, 0351 “Head CT scan”
• Operating Room (036X), Anesthesia (037X) – 0361 “Minor surgery”, 0370 “General anesthesia”
• Medical/Surgical Supplies (027X) – 0274 “Prosthetic/orthotic devices”
• Therapy services (042X Physical Therapy, 041X Respiratory, etc.)

^[1]

The description should be taken directly from the “Description” column in the Noridian list. For example, for revenue code 0450 (Emergency Room – General), the description must be “Emergency Room – General.”

The MassHealth UB-04 Guide confirms that paper claims must use the UB‑04 form for acute inpatient, outpatient, and many other provider types. Each line on the form includes a revenue description ^[2].

Step-by-Step Claim Example

Scenario: An acute inpatient hospital stay for a patient in a semi‑private medical/surgical bed, with pharmacy and laboratory services.

Step 1 – Room and Board Line

• Field 42: 0121 (Revenue Code)
• Field 43: “Room and Board Semi‑private – Medical/Surgical/GYN” (from Noridian)
• Field 47 (Total Charges): $2,500.00

Step 2 – Pharmacy Line

• Field 42: 0251 (Generic drugs)
• Field 43: “Pharmacy – Generic drugs”
• Field 47: $350.00

Step 3 – Laboratory Line

• Field 42: 0301 (Chemistry)
• Field 43: “Laboratory – Chemistry”
• Field 47: $180.00

Step 4 – Additional Lines (CT Scan, Respiratory, etc.)
Repeat the pattern using the exact description from the Noridian list for each revenue code.

Completing the Form:

• If more than 22 lines are needed, follow the MassHealth UB-04 Guide instruction: for inpatient claims exceeding 22 lines, submit electronically; for outpatient, bundle services onto a single form ^[2].
• Double‑check that each description is spelled correctly and does not exceed 23 characters. Noridian descriptions are already within this limit; do not abbreviate further.

Common Mistakes & Audit Red Flags

1. Mismatched Description and Revenue Code

   • Example: Using revenue code 0121 (semi‑private medical/surgical) but entering “Room and Board Private – General.” This can trigger a Medicare audit. Always verify against ^[1].

2. Blank or Generic Description

   • Leaving Field 43 blank or using “Other” when a specific sub‑code exists. For instance, using “Radiology – General” (0320) instead of a specific sub‑code like “Chest X‑ray” (0324) may result in claim rejection.

3. Truncation or Abbreviation

   • Because Field 43 is limited to 23 characters, some providers shorten official descriptions (e.g., “ICU Surg” for “Surgical ICU”). Payers expect the full standard description. Noridian’s list already provides descriptions that fit; do not modify them.

4. Using Outdated Codes/Descriptions

   • Revenue codes are periodically updated (e.g., new code 0161 for “Hospital at home R&B” effective July 1, 2022). Using an old description can cause denial ^[1].

5. Exceeding 22 Lines on a Paper Claim

   • The MassHealth UB-04 Guide states that only 22 revenue lines fit on a single form. Attempting to add a 23rd line on paper will void the claim. Submit electronically or bundle outpatient services ^[2].

Audit Red Flags:

• Revenue description that does not match the revenue code in Field 42.
• Repeated use of “General” (code XXX0) when a more specific code is appropriate.
• Descriptions that appear to be copy‑pasted from software without verification.

Related Codes/Fields

The following table lists fields on the UB‑04 that interact directly with the Revenue Description (Field 43). Always refer to your payer’s specific instructions (e.g., ^[2]) for full details.

Field	Name	Relationship to Field 43
42	Revenue Code	The numeric code that determines which description must be entered in Field 43. Every revenue code has a standard description from the Noridian list [1].
44	HCPCS / Rate / HIPPS Code	Used when a revenue code requires a more specific HCPCS code (e.g., for drugs or supplies). The description in Field 43 must still match the revenue code, not the HCPCS.
45	Service Date	Dates of service for each revenue line. The description must be consistent with the type of service on that date.
46	Units of Service	Number of units for the revenue code. Example: 2 “Inhalation services” (Revenue Code 0412).
47	Total Charges	Dollar amount for the revenue line. The description helps justify the charge amount.
48	Non‑Covered Charges	If a portion of the charge is non‑covered, the description must accurately reflect the service.

Note: The MassHealth UB-04 Guide provides complete instructions for all form fields, including the number of lines permitted and the requirement to bundle outpatient charges ^[2]. Always cross‑reference your revenue code descriptions with the official Noridian list before submitting.

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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