Medicare AdvantageBilling CodesHigh impact
[Ohio] Revenue Code Billing Requirements
CareSource·OH·Claims & Billing
Effective date
Jan 15, 2026
We identified it
May 9, 2026
Summary
Effective January 15, 2026, CareSource will implement enhanced claims editing that will deny claims billed with specific revenue codes (0500-0509, 0583, 0660-0669, 0906-0907, 0931-0932, 1000-1006, 2100-2109, 3100-3109) when submitted with bill types 0120-012Z, 0130-013Z, or 0140-014Z. Providers must audit their billing processes to ensure these revenue code and bill type combinations are not used, or claims will be systematically denied.
Action Required
By January 15, 2026: Billing team must audit and update billing software and internal billing procedures to PREVENT claims from being submitted with the following revenue code and bill type combinations: (1) Revenue codes 0500-0509, 0583, 0660-0669, 0906-0907, 0931-0932, 1000-1006, 2100-2109, or 3100-3109 paired with bill types 0120-012Z, 0130-013Z, or 0140-014Z. Billing staff should: (1) Review current billing templates and encounter forms to identify where these combinations may be used; (2) Configure billing system edits to flag or prevent submission of these combinations; (3) Communicate to clinical and administrative staff which services cannot use these bill type codes; (4) Establish a verification process before claim submission. Failure to comply will result in systematic claim denials for all affected claims processed on or after the effective date. Contact CareSource Provider Services for clarification on compliant alternatives for affected service lines: D-SNP (1-833-230-2176), Marketplace (1-833-230-2101), Medicaid (1-800-488-0134), or MyCare (1-800-488-0134), Monday-Friday during business hours ET.