Which coding framework is used to describe outpatient services on UB-04 claims?

• A. ICD-10-PCS
• B. CPT/HCPCS
• C. ICD-9-CM
• D. DRG codes

Answer: (B)

Outpatient services on UB-04 claims are described with CPT/HCPCS codes. CPT (Current Procedural Terminology) covers most physician procedures and many outpatient services, while HCPCS Level II extends CPT to additional items like medications, supplies, and durable medical equipment. These codes specifically document the procedures and services rendered in the outpatient setting on the claim. ICD-10-PCS codes are used for inpatient procedures, ICD-9-CM is an older diagnosis/procedure coding system no longer in general use, and DRG codes are payment classifications for inpatient stays, not the codes used to describe outpatient services.