Which form is used to bill hospitals and allows revenue codes?

Which form is used to bill hospitals and allows revenue codes?

• A. CMS-1500
• B. Form Locator
• C. UB-04
• D. ICD-9-CM

Answer: (C)

The form used by hospitals to bill payers and to categorize charges by department or service area is the UB-04. This claim form is designed for facility-based providers, so it supports revenue codes that identify where the service was provided (for example, emergency department, radiology, inpatient room and board, surgery, etc.) and pair those codes with the associated charges. Revenue codes help the payer see how costs are distributed across different hospital departments and ensure proper reimbursement. Professional bills, by contrast, use the CMS-1500 form and rely on CPT/HCPCS procedure codes, not revenue codes. ICD-9-CM (and ICD-10-CM) are diagnosis coding systems used on claims, not forms themselves.

The form used by hospitals to bill payers and to categorize charges by department or service area is the UB-04. This claim form is designed for facility-based providers, so it supports revenue codes that identify where the service was provided (for example, emergency department, radiology, inpatient room and board, surgery, etc.) and pair those codes with the associated charges. Revenue codes help the payer see how costs are distributed across different hospital departments and ensure proper reimbursement.

Professional bills, by contrast, use the CMS-1500 form and rely on CPT/HCPCS procedure codes, not revenue codes. ICD-9-CM (and ICD-10-CM) are diagnosis coding systems used on claims, not forms themselves.