LINE CODES. CMS Line Label Codes

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1 LINE CODES The following worksheets are cost center coded worksheets: A, B series, C series, D series and L series. CMS Line Label Codes Std. 1 Capital Related Cost - Buildings & Fixtures Std. 2 Capital Related Cost - Movable Equipment Std. 3 Other Capital Related Cost Std. 4 Employee Benefits Std. 5 Administrative & General Communications Other Administrative & General Data Processing Management Services Admitting Purchasing, Receiving, and Stores Cashiering and Accounts Receivable NonPatient Telephones Std. 6 Maintenance and Repairs Std. 7 Operation of Plant Std. 8 Laundry & Linen Service Std. 9 Housekeeping Std. 10 Dietary Std. 11 Cafeteria Std. 12 Maintenance of Personnel Std. 13 Nursing Administration Std. 14 Central Services and Supply Std. 15 Pharmacy Std. 16 Medical Records & Library Std. 17 Social Service Other General Service Cost Centers Inservice Education Std. 19 Nonphysician Anesthetists Std. 20 Nursing School Std. 21 Interns & Residents (Approved) - Salary & Fringe Std. 22 Interns & Residents (Approved) - Other Costs Std. 23 Paramedical Education Program Std. 30 Adults & Pediatrics (General Routine Care) Std. 31 Intensive Care Unit Std. 32 Coronary Care Unit Std. 33 Burn Intensive Care Unit Std. 34 Surgical Intensive Care Unit Psychiatric ICU Pediatric ICU Neonatal ICU Trauma ICU Detoxification ICU Premature ICU Std. 40 Subprovider IPF Std. 41 Subprovider IRF 04100

2 Std. 42 Other Subprovider Std. 43 Nursery Std. 44 Skilled Nursing Facility Std. 45 Nursing Facility Std ICF/MR Std. 46 Other Long Term Care Std. 50 Operating Room Prosthetic Devices Circumcision Endoscopy Std. 51 Recovery Room Std. 52 Delivery Room & Labor Room Birthing Center Std. 53 Anesthesiology Acupuncture Std. 54 Radiology - Diagnostic Nuclear Medicine - Diagnostic Ultra Sound Mammography Angiocardiography Echocardiography Std. 55 Radiology - Therapeutic Nuclear Medicine - Therapeutic Electroshock Therapy Chemotherapy Std. 56 Radioisotope Std. 57 CT Scan Std. 58 MRI Std. 59 Cardiac Catheterization Std. 60 Laboratory Oncology Biopsy Hematology Cytology Immunology Bacteriology & Microbiology Chemistry Vascular Lab Laboratory - Pathological Laboratory - Clinical Histology Urology Gastro Intestinal Service Std. 61 PBP Clinical Lab Service Program Only Std. 62 Whole Blood & Packed Red Blood Cells Std Blood Clotting for Hemophiliacs Std. 63 Blood Storing, Processing, & Transfusing Std. 64 Intravenous Therapy

3 Std. 65 Respiratory Therapy Pulmonary Function Testing Std. 66 Physical Therapy Osteopathic Therapy Std. 67 Occupational Therapy Std. 68 Speech Pathology Std. 69 Electrocardiology EKG and EEG Electromyography Cardiopulmonary Stress Test Cardiology Holter Monitor Std. 70 Electroencephalograpy Std. 71 Medical Supplies Charged to Patients Std. 72 Implant Devices Charged to Patients Std. 73 Drugs Charged to Patients Std. 74 Renal Dialysis Std. 75 ASC (Non-Distinct Part) Audiology Dental Services Recreational Therapy Psychiatric / Psychological Services Ophthalmology Other Ancillary Cost Centers Cardiac Rehabilitation Hyperbaric oxygen therapy Lithotripsy Std. 88 Rural Health Clinic Std. 89 Federally Qualified Health Center Std. 90 Clinic Std. 91 Emergency Std. 92 Observation Beds (Distinct Part) Std. 92 Observation Beds (Non-Distinct Part) Family Practice Telemedicine All Other Outpatient Cost Centers Std. 94 Home Program Dialysis Std. 95 Ambulance Services Std. 96 Durable Medical Equipment -- Rented Support Surfaces -- Rented Std. 97 Durable Medical Equipment -- Sold Support Surfaces -- Sold Other Reimbursable Cost Centers (excl. HHA & CORF) CMHC CORF OPT OOT OSP

4 Std. 100 Intern - Resident Svc. (not in Approved Program) Std. 101 Home Health Agency Std. 105 Kidney Acquisition Std. 106 Heart Acquisition Std. 107 Liver Acquisition Std. 108 Lung Acquisition Std. 109 Pancreas Acquisition Std. 110 Intestine Acquisition Std. 111 Islet Cell Acquisition Other Organ Acquisition Std. 113 Interest Expense Std. 114 Utilization Review -- SNF Std. 115 ASC (Distinct Part) Std. 116 Hospice All Other Special Purpose Cost Centers Std. 190 Gift, Flower, Coffee Shop, & Canteen Std. 191 Research Std. 192 Physicians' Private Offices Std. 193 Nonpaid Workers Other Nonreimbursable Cost Centers

5 COLUMN CODES The following column codes are for the following worksheets: B, Part I, Columns 1 through 23 B, Part II, Columns 1 through 23 B-1, Columns 1 through 23 CMS Column Label Std. 1 1 Capital Related Cost - Buildings & Fixtures Std. 2 2 Capital Related Cost - Movable Equipmen Std. 3 3 Other Capital Related Cost Std. 4 4 Employee Benefits Std. 5 Administrat Communications Other Administrative & General Data Processing Management Services Admitting Purchasing, Receiving, and Stores Cashiering and Accounts Receivable NonPatient Telephones Std. 6 Maintenance and Repairs Std. 7 Operation of Plant Std. 8 Laundry & Linen Service Std. 9 Housekeeping Std. 10 Dietary Std. 11 Cafeteria Std. 12 Maintenance of Personnel Std. 13 Nursing Administration Std. 14 Central Services and Supply Std. 15 Pharmacy Std. 16 Medical Records & Library Std. 17 Social Service Other General Service Cost Centers Inservice Education Std. 19 Nonphysician Anesthetists Std. 20 Nursing School Std. 21 Interns & Residents (Approved) - Salary & Fringe Std. 22 Interns & Residents (Approved) - Other Costs Std. 23 Paramedical Education Program Page 5

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