UB-04 claim form is also known as CMS-1450. Which CMS form name corresponds to this form?

UB-04 claim form is also known as CMS-1450. Which CMS form name corresponds to this form?

• A. CMS-1450
• B. CMS-1500
• C. ICD-10-PCS
• D. NUBC

Answer: (A)

The UB-04 is the standard institutional claim form used for hospital and facility billing, and its official CMS form name is CMS-1450. This designation comes from CMS, where CMS-1450 identifies the form used to submit facility charges. The other names refer to different things: CMS-1500 is the professional claim form used by physicians and non-institutional providers; ICD-10-PCS is the inpatient procedure coding system; NUBC is the committee that standardizes billing data and forms, not a specific form. So the form name that matches UB-04 is CMS-1450.

The UB-04 is the standard institutional claim form used for hospital and facility billing, and its official CMS form name is CMS-1450. This designation comes from CMS, where CMS-1450 identifies the form used to submit facility charges. The other names refer to different things: CMS-1500 is the professional claim form used by physicians and non-institutional providers; ICD-10-PCS is the inpatient procedure coding system; NUBC is the committee that standardizes billing data and forms, not a specific form. So the form name that matches UB-04 is CMS-1450.