Certified Revenue Cycle Representative (CRCR) Practice Exam

What type of billing system is used primarily for outpatient services?

1. UB-04 form

2. CMS 1500 form

3. EHR billing system

4. International Classification of Diseases (ICD) coding

The correct answer is: CMS 1500 form

The CMS 1500 form is specifically designed for billing for outpatient services, primarily used by non-institutional providers such as physicians, therapists, and other healthcare professionals. This form allows these providers to submit claims to Medicare, Medicaid, and private insurance carriers for payment for services rendered to patients in an outpatient setting. It captures essential information related to patient demographics, diagnosis codes, procedure codes, and billing details. In contrast, the UB-04 form is typically used for inpatient services and institutional providers such as hospitals and skilled nursing facilities, making it unsuitable for outpatient billing purposes. An electronic health record (EHR) billing system is a method of managing billing processes but does not specifically indicate the type of billing form used. International Classification of Diseases (ICD) coding refers to the diagnosis and procedure coding but does not pertain to a specific billing form itself. Thus, the CMS 1500 form stands out as the correct choice for outpatient billing.