BACKGROUND: Achieving Universal Health Coverage (UHC) in low- and middle-income countries (LMICs) requires a robust digital infrastructure capable of monitoring healthcare services and associated costs. A major barrier is the absence of a standardized and comprehensive nomenclature for billable healthcare services. Assessment across five hospitals in Burundi confirmed this problem by showing significant inconsistencies in service naming and coding. This study presents the development of a Universal Nomenclature of Health Services (UNHS) for Burundi, a meta-classification for billable health services, designed to align international classification systems with local operational needs.METHODS: The methodology comprised a need assessment, literature review, the selection of relevant international standards, national adaptation, integration of operational sub-codes, and validation through stakeholder engagement.RESULTS: The developed meta-classification based on six international standards (ICD-10-PCS, CPT, HCPCS, LOINC, RxNorm, and UB04) produces 82,433 codes covering 97.7% of health services relevant to UHC tracking.CONCLUSIONS: This paper details the methodology, structure, coverage, and implementation of the UNHS, offering a scalable model for improving health information system interoperability and UHC monitoring in LMICs.