This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-rev-cntr-stus-ind-cd defines the following codes:
| Code | Display | Definition |
| A | Services not paid under OPPS; uses a different fee schedule (e.g., ambulance, PT, mammography) | Services not paid under OPPS; uses a different fee schedule (e.g., ambulance, PT, mammography) |
| B | Non-allowed item or service for OPPS; may be paid under a different bill type (e.g., CORF) | Non-allowed item or service for OPPS; may be paid under a different bill type (e.g., CORF) |
| C | Inpatient procedure (not paid under OPPS) | Inpatient procedure (not paid under OPPS) |
| E | Non-allowed item or service (not paid by OPPS or any other Medicare payment system) | Non-allowed item or service (not paid by OPPS or any other Medicare payment system) |
| F | Corneal tissue acquisition, certain CRNA services and Hepatitis B vaccinations | Corneal tissue acquisition, certain CRNA services and Hepatitis B vaccinations |
| G | Drug/biological pass-through (separate APC includes this pass-through amount) | Drug/biological pass-through (separate APC includes this pass-through amount) |
| H | Device pass-through (separate cost-based pass-through payment, not subject to coinsurance) | Device pass-through (separate cost-based pass-through payment, not subject to coinsurance) |
| J | New drug or new biological pass-through | New drug or new biological pass-through |
| J1 | Primary service and all adjunctive services on the claim (comprehensive APC; effective 01/2015) | Primary service and all adjunctive services on the claim (comprehensive APC; effective 01/2015) |
| K | Non pass-through drug/biological, radio-pharmaceutical agent, certain brachytherapy sources (paid under OPPS; separate APC payment) | Non pass-through drug/biological, radio-pharmaceutical agent, certain brachytherapy sources (paid under OPPS; separate APC payment) |
| L | Flu/PPV vaccines | Flu/PPV vaccines |
| M | Service not billable to fiscal intermediary [now a MAC] (not paid under OPPS) | Service not billable to fiscal intermediary [now a MAC] (not paid under OPPS) |
| N | Packaged incidental service (no separate APC payment) | Packaged incidental service (no separate APC payment) |
| P | Paid partial hospitalization per diem APC payment | Paid partial hospitalization per diem APC payment |
| Q1 | Separate payment made; OPPS - APC (effective 2009) | Separate payment made; OPPS - APC (effective 2009) |
| Q2 | No separate payment made; OPPS - APC were packaged into payment for other services (effective 2009) | No separate payment made; OPPS - APC were packaged into payment for other services (effective 2009) |
| Q3 | May be paid through a composite APC-based on composite-specific criteria or separately through single code APCs when the criteria are not met (effective 2009) | May be paid through a composite APC-based on composite-specific criteria or separately through single code APCs when the criteria are not met (effective 2009) |
| R | Blood products | Blood products |
| S | Significant procedure not subject to multiple procedure discounting | Significant procedure not subject to multiple procedure discounting |
| T | Significant procedure subject to multiple procedure discounting | Significant procedure subject to multiple procedure discounting |
| U | Brachytherapy | Brachytherapy |
| V | Medical visit to clinic or emergency department | Medical visit to clinic or emergency department |
| W | Invalid HCPCS or invalid revenue code with blank HCPCS | Invalid HCPCS or invalid revenue code with blank HCPCS |
| X | Ancillary service | Ancillary service |
| Y | Non-implantable DME(e.g., therapeutic shoes; not paid under OPPS -bill to DMERC) | Non-implantable DME(e.g., therapeutic shoes; not paid under OPPS -bill to DMERC) |
| Z | Valid revenue with blank HCPCS and no other SI assigned | Valid revenue with blank HCPCS and no other SI assigned |
