Uniform Billing, version 04 (UB-04) Certification Practice Test

These questions are part of the practice quiz. Start practicing

• Patient Information is found in which Form Locator range?
• How is secondary payer data captured on a UB-04 claim?
• Which Form Locator holds the Patient Birthday on the UB-04 form?
• What does a line item with a revenue code and a charge represent?
• Which code corresponds to the B-range status indicator?
• Which Form Locator holds Occurrence Span Dates and Codes and is required, if applicable?
• Which coding framework is used to describe outpatient services on UB-04 claims?
• Which Form Locator should be used for the Admitting Diagnosis Code?
• Which Form Locator is used for the Statement Covers Period field on the UB-04 form?
• Total Charges by Revenue Code are recorded in which Form Locator?
• Which element is situational for the Pay-To information on UB-04?
• What links a service line to its service area and charges on UB-04?
• The field for Treatment Authorization Codes corresponds to which Form Locator?
• The field for Document Control Number is associated with which Form Locator?
• How should UB-04 data be validated before submission?
• What is a key difference between inpatient UB-04 coding and payment vs outpatient UB-04 in terms of coding and payment?
• Which Form Locator is designated for Future Use (N/A) in this UB-04 scheme?
• Which Form Locator corresponds to the Estimated Amount Due and is required?
• Diagnostic Information includes which data elements?
• Which Form Locator is used for provider name and address?
• Which code range is defined as Not Applicable in the A-range?
• Which Form Locator contains the Principal Diagnosis Code/Other Diagnosis Codes?
• Payer Information includes which element?
• Which items are included in the Admission/Discharge/Transfer section on UB-04?
• Which Form Locator is described as Future Use?
• Which Form Locator is Principal Procedure Code/Date?
• UB-04 provider identifiers are used to identify who rendered services. Which of the following statements is accurate?
• Billing Information includes which item on the UB-04 form?
• How are ICD-10-CM diagnoses reported on UB-04?
• Which Form Locator stores the Insured's Unique ID?
• Form Locator 1 requires which data element?
• The field for the Insured's Group Number uses which Form Locator?
• Which Form Locator is External Cause of Injury Code?
• On an UB-04 form, the Revenue Code is reported in which Form Locator?
• Which UB-04 feature reports monetary values such as patient responsibility?
• What does the Discharge Status indicate on UB-04?
• What does the Type of Bill (TOB) indicate on UB-04?
• Which data elements are used to bill hospital outpatient services on UB-04?
• Which statement best describes the difference between header data and detail data on UB-04?
• What are Other Provider fields on UB-04 used to report?
• Value Codes and Amounts are reported in which Form Locator group?
• Which of the following is NOT part of the recommended pre-submission validation for UB-04 data?
• Which Form Locator includes 1G as the ID qualifier?
• Which Form Locator is used to report the Revenue Code Description?
• Which Form Locator covers the Admission Hour on the UB-04 form?
• The Units of Service are reported under which Form Locator?
• Which Form Locator is designated as Situational (not always required) on the UB-04 form?
• Occurrence Span Dates and Codes are recorded in which Form Locator range on UB-04?
• What is the purpose of a line item on UB-04?
• Which UB-04 field identifies the physician who performed the principal operation or procedure?
• What codes are typically used to report outpatient procedures on UB-04?
• Which code corresponds to a Not Applicable status in the mapping?
• How are primary and secondary diagnoses linked to line items?
• The 'Employer Name' field is associated with which Form Locator?
• What do Occurrence Span Codes specify on UB-04?
• Occurrence Codes and Dates are recorded in which Form Locator range on UB-04?
• Which data element is included in Payer Information?
• What are Condition Codes used for on UB-04?
• What is the Patient Control Number on UB-04?
• What is Service Units and why is it important?
• Which Form Locator corresponds to Payer Identification (Name) and is required on the UB-04 form?
• Which scenario best describes span service capture on UB-04?
• Which Form Locator is used for the Patient Name on the UB-04 form?
• Which of the following best describes header data on UB-04?
• How are ICD-10-PCS procedures reported on UB-04 for inpatient claims?
• In relation to DRG assignment, which statement is correct?
• Form Locator 3a requires which data element?
• What is the role of the NPI on UB-04 claims?
• How are hospice or long-term care services represented on UB-04?
• Which Form Locator is designated as Future Use (N/A)?
• How are diagnoses assigned to a line item when multiple diagnoses exist?
• The field for the Insured's Group Name corresponds to which Form Locator?
• What is the data status for the External Cause of Injury Code field?
• What is the primary purpose of payer identifiers on UB-04?
• What is reported in the Dates of Service for a line item?
• Which Form Locator numbers correspond to the Other ID field?
• Which payer information is included on UB-04?
• What is a common UB-04 data error?
• Where are HCPCS codes and rates entered on the UB-04 form?
• Which Form Locator carries the Treatment Authorization Codes, if applicable?
• Which Form Locator records Patient Discharge Status on the UB-04 form?
• Which Form Locator corresponds to the Patient ID field on the UB-04 form?
• What are Revenue Codes used for on UB-04?
• Why is data quality critical for UB-04?
• Condition Codes are recorded in which Form Locator range on UB-04?
• Which Form Locator would you use to record the Accident State?
• Which Form Locator is Attending Name/ID-Qualifier 1G?
• What is the Document Control Number used for?
• Which Form Locator is Prior Payments, Required, if applicable?
• Which data elements are included in the UB-04 header sections to reflect patient demographics?
• If a claim notes beneficiary liability or third-party involvement, which code category is used?
• Which Form Locator would you use to record Type of Admission/Visit?
• Which factor affects DRG determination and payment for inpatient UB-04 claims?
• Which code identifies the Attachment Control Number?
• Which data elements on UB-04 capture patient demographic information?
• Billing Information is located in which Form Locator range?
• Which code indicates a Not Applicable status in the B range such as B1-B2?
• Which code indicates Not Applicable in the A-range?
• What does AD-B0 indicate in the mapping?
• What are Occurrence Codes used for on UB-04?
• Which Form Locator stores the NPI field?
• Which of the following statements is true about the relationship between diagnoses and service lines on UB-04?
• Payer-side edits are applied during which part of UB-04 processing?
• Which Form Locator is used for the Admission Date on the UB-04 form?
• Form Locator 4 corresponds to which required data element?
• Which Form Locator is Operating ID?
• Which Form Locator records Type of Admission/Visit on the UB-04 form?
• Which Form Locator is designated for Future Use and is not applicable?
• Which Form Locator is required for Patient Name on the UB-04 form?
• Which statement best describes how Charges, Payments, and Adjustments are represented on UB-04?
• Which Form Locator holds the Admitting Diagnosis Code and is Required?
• Which code explicitly represents the Attachment Control Number?
• Which Form Locator has the status Situational?
• How is patient responsibility represented on UB-04?
• Which Form Locator is Remarks?
• Which code would be used to denote a Required field?
• Which Form Locator is Insured's Name and Required?
• Under HIPAA, UB-04 electronic submission uses which format?
• Which Form Locator records the Patient Sex on the UB-04 form?
• Non-Covered Charges are reported in which Form Locator?
• What is the data requirement status for the Principal Procedure Code/Date field?
• Which Form Locator is the Future Use field on the UB-04 form?
• Which Form Locator is marked Not Applicable (N/A) on the UB-04 form?
• Which Form Locator holds Occurrence Codes and Dates and is required, if applicable?
• What is the Operating Physician field used for on UB-04?
• Which Form Locator records Source of Admission on the UB-04 form?
• What is a Diagnosis Pointer?
• Which Form Locator is used for Attending Name/ID-Qualifier 1G and is Required?
• Which Form Locator is designated for Future Use on the UB-04 form?
• Which Form Locator captures the NPI and is Required?
• Which code indicates a Not Applicable status in the A-range A5-AB?
• Which Form Locator has the status Optional?
• The 'Principal Diagnosis Code/Other Diagnosis Codes' uses which Form Locator?
• Who generates the Claim Control Number on UB-04 claims?
• Accident State is recorded in which Form Locator on UB-04?
• A common UB-04 data error is missing dates of service. What is the typical consequence?
• How is the length of stay used in UB-04 processing?
• Which of the following best describes where revenue codes are applied on the UB-04 claim?
• In the Form Locator 81 coding scheme, what does 0-0A represent?
• What is the purpose of diagnosis pointers on a UB-04 claim?
• How does UB-04 support multiple payers for a single claim?
• Which statement about the Claim Control Number is true?
• Which Form Locator set contains the fields for Value Codes and Amounts (39 through 41)?
• What does Assignment of Benefits indicate on UB-04?
• How are hospital outpatient services billed on UB-04?
• What is the purpose of the Date of Service field when a service spans multiple days?
• Which Form Locator precedes the Principal Procedure Code/Date field and is labeled Future Use?
• Which Form Locator corresponds to the Health Plan Identification Number and has a Situational status?
• What is the Attending Physician field used for on UB-04?
• Which Form Locator corresponds to the Employer Name with a Situational status?
• Which Form Locator is used to report the HCPCS/Rates?
• The 'Diagnosis/Procedure Code Qualifier' uses which Form Locator?
• Which item is included in Provider Information on the UB-04 form?
• When there are multiple payers, which data is included on the UB-04 claim to support coordination of benefits?
• Which Form Locator is Other ID?
• Which Form Locator corresponds to Patient's Reason for Visit Code?
• Which Form Locator is Assignment of Benefit Certification?
• Which Form Locator is used for Release of Info Certification on the UB-04 form?
• Which Form Locator captures the Patient Address on the UB-04 form?
• What does the Statement Covers Period field denote on UB-04?
• Which code represents the Attachment Control Number in a different phrasing?
• Which Form Locator records Discharge Hour on the UB-04 form?
• Which Form Locator is the Assignment of Benefit Certification and Required?
• Value Codes and Amounts on UB-04 report what?
• Which Form Locator is Prior Payments?
• What happens when UB-04 data are missing required fields?
• Form Locator 3b is designated as which data element?
• What does the revenue code on a line item indicate?
• What is the primary purpose of DRG groups in the UB-04 environment?
• Which Form Locator would you use to record the Discharge Hour?
• The description corresponding to each Revenue Code is entered in which Form Locator?
• Form Locator 2 is used for which field?
• How are diagnoses connected to specific service lines on a UB-04 claim?
• Which data element is required in Form Locator 3a?
• Which Form Locator would you use to record the Source of Admission?
• Which Form Locator is used to report the Service Date?
• What does B3 denote in the code-field qualifiers?
• Which Form Locator is used for PPS Code?
• The date of service is captured in which Form Locator?
• Which Form Locator is required for Admission Date on the UB-04 form?
• Which code set is used to describe outpatient procedures on UB-04?
• How should corrections or resubmissions on UB-04 be submitted?
• Which Form Locator is Patient's Relation to Insured and Required?
• How are coinsurance and deductible handled on UB-04?
• Which field records the date range of service when a line item spans multiple days?
• Where are payer-specific edits checked during UB-04 submission?
• What is the UB-04 form primarily used for?
• What might require prior authorization data on UB-04?
• Which code corresponds to the B1-B2 range?
• Which Form Locator corresponds to the Optional field?
• Which code is used to mark Not Applicable in the AD group?
• Which Form Locator is used to report the Revenue Code itself on the UB-04 form?
• Which Form Locator is used for Remarks and appears last among the Form Locator fields?
• The form section for the Responsible Party Name and Address is located at which Form Locator?