Which code set is used to describe outpatient procedures on UB-04?

• A. ICD-10-CM codes.
• B. ICD-10-PCS codes.
• C. DRG codes.
• D. CPT/HCPCS codes.

Answer: (D)

Outpatient procedures on the UB-04 are described with CPT/HCPCS codes. CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System) cover the procedures, services, and supplies provided in outpatient and ambulatory settings, including physician and facility services. ICD-10-CM codes are for diagnoses, not procedures. ICD-10-PCS codes describe inpatient hospital procedures, not outpatient ones. DRG codes are payment groupings used for inpatient reimbursement, not the specific outpatient procedures performed. So CPT/HCPCS is the appropriate code set for outpatient procedure documentation on the UB-04.