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Printed Date: 9/22/2015
If any of the following criteria are met:
*Revenue code 52x (rev code 0520 has been expanded to include the complete range of 052x for FQHC (TOB 77x, provider range 1000–1199 or 1800–1989) for dos 4/1/2010 and after. Note: effective 4/1/2010 FQHCs, free standing (xx1000–xx1199) and provider-based facilities (xx1800–xx1989), must be submitted on TOB 77x.
All references to TOB 73x now apply to TOB 77x. Rev codes 052x can be billed with multiple line item if billing preventative service HCPCS codes effective with dos 1/1/2011.
Verify reasons 1–9, as applicable. Correct and resubmit the claim.
CMS Internet Only Manual (IOM), Publication 100-04, chapter 9 (PDF, 241 KB).
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Last Updated: 12/16/2019