Which data elements are used to bill hospital outpatient services on UB-04?

• A. Discharge disposition only
• B. Patient name and birthdate only
• C. Revenue codes, dates of service, and CPT/HCPCS (or ICD-10-PCS) procedure codes
• D. Room number and bed type only

Answer: (C)

For hospital outpatient billing on UB-04, you need to capture the exact services provided and link them to the charges. Revenue codes identify the department or type of service (like radiology, lab, or outpatient procedures). Dates of service show when each service occurred, which is essential for timing, eligibility, and proper pricing. Procedure codes (CPT/HCPCS, or ICD-10-PCS where applicable) describe the specific service or procedure performed, mapping directly to the billed charges and payer reimbursement. Together, these elements—which specify what was done, where it was done, and when it happened—allow the claim to be correctly categorized and paid.

Discharge disposition, room number, bed type, and basic patient identifiers like name and birthdate do not convey the actual services or charges on an outpatient claim, so they cannot stand alone for billing purposes. They may appear on the record for other reasons, but they don’t replace the need for revenue codes, dates of service, and procedure codes.