Completing The UB-04 Claim Form – Introduction Practice Test

Which field holds the country code used when services occur outside the United States?

Birthdate field Source of referral field Country code field DHR field

Correct Answer:

Country code field

Explanation:

When a claim includes services performed outside the United States, you need a field that specifically records the country where the service occurred. The country code field is the designated place on the UB-04 form to store that foreign country code, ensuring the claim is processed with the correct international billing rules and location context. The birthdate field is about the patient’s date of birth, not service location. The source of referral field shows who referred the patient, not where the service happened. The DHR field carries other administrative or clinical data unrelated to the country of service.

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