Question 1

There are a total of 67 form locators located on the UB-04.

Accepted Answer

False

Question 2

Revenue codes are facility specific.

Accepted Answer

False

Question 3

Revenue Code 0450 designates services performed in the Emergency Department.

Accepted Answer

Revenue Code 0450 is used to designate services provided in the Emergency Department according to the standard healthcare billing practices.

Question 4

Professional services may not be billed on the UB-04 (CMS-1450).

Accepted Answer

The answer of Professional services may not be billed on...

Question 5

Only one payer may be listed on the UB-04 (CMS-1450).

Accepted Answer

The UB-04 (CMS-1450) form allows for multiple payers to be listed, accommodating primary, secondary, and tertiary insurance information.

Question 6

When a claim is an interim claim, meaning additional services/service dates for the encounter will follow on another claim, this is indicated by the use of a revenue code.

Accepted Answer

An interim claim is indicated by the use of specific claim frequency codes, not revenue codes.

Question 7

When a claim submitted is employment related, it is designated as a condition code.

Accepted Answer

When a claim submitted is employment related, it is designated as a condition code.

Question 8

The responsible party indicated in form locator (FL) 38 should always be the patient.

Accepted Answer

Form locator (FL) 38 on a UB-04 form is used to indicate the responsible party for the bill, which could be the patient or another entity such as an insurance company or a guarantor.

Question 9

In the case of a 29-year-old college student requesting services, the responsible party should be the parents.

Accepted Answer

A 29-year-old is considered an adult and is typically responsible for their own services, not their parents.

Question 10

A revenue code in the 013X-015X categories would be appropriate for an outpatient hospital claim.

Accepted Answer

The answer of A revenue code in the 013X-015X categories...

Question 11

A dirty claim refers to a claim that:

Accepted Answer

A dirty claim is one that contains errors or omissions, which can lead to delays in processing or denial of the claim.

Question 12

The claim form that is universally accepted to submit charges performed by the facility is known as:

Accepted Answer

The UB-04 (CMS-1450) is the standard claim form used by facilities, such as hospitals, to bill for services provided.

Question 13

Data elements contained on the UB-04 claim are referred to as:

Accepted Answer

The data elements on the UB-04 claim form are referred to as "form locators."

Question 14

An admission time of 7:58 a.m. would be recorded on the UB-04 claim form in FL 13 as:

Accepted Answer

The answer of An admission time of 7:58 a.m. would...

Question 15

A bill type of 131 would indicate the services were provided as:

Accepted Answer

The answer of A bill type of 131 would indicate...

Question 16

Condition codes utilize what FL numbers?

Accepted Answer

Condition codes are typically reported in FL (Form Locator) numbers 18-28 on healthcare claim forms.

Question 17

Condition codes are utilized for:

Accepted Answer

Condition codes are used to identify special circumstances, events, or conditions that affect the services provided, rather than diagnoses, causes of injury, or procedures.

Question 18

FL 38 would identify the:

Accepted Answer

The answer of FL 38 would identify the:
...

Question 19

Revenue codes should be placed in what order?

Accepted Answer

Revenue codes should be placed in numeric, ascending order to ensure proper processing and organization in billing systems.

Question 20

FL 67 should list:

Accepted Answer

The answer of FL 67 should list:
...

Quiz 4: UB-04 Overview CMS-1450

There are a total of 67 form locators located on the UB-04.

Revenue codes are facility specific.

Revenue Code 0450 designates services performed in the Emergency Department.

Professional services may not be billed on the UB-04 (CMS-1450).

Only one payer may be listed on the UB-04 (CMS-1450).

When a claim is an interim claim, meaning additional services/service dates for the encounter will follow on another claim, this is indicated by the use of a revenue code.

When a claim submitted is employment related, it is designated as a condition code.

The responsible party indicated in form locator (FL) 38 should always be the patient.

In the case of a 29-year-old college student requesting services, the responsible party should be the parents.

A revenue code in the 013X-015X categories would be appropriate for an outpatient hospital claim.

A dirty claim refers to a claim that:

The claim form that is universally accepted to submit charges performed by the facility is known as:

Data elements contained on the UB-04 claim are referred to as:

An admission time of 7:58 a.m. would be recorded on the UB-04 claim form in FL 13 as:

A bill type of 131 would indicate the services were provided as:

Condition codes utilize what FL numbers?

Condition codes are utilized for:

FL 38 would identify the:

Revenue codes should be placed in what order?

FL 67 should list: