What types of codes are reported on CMS-1500 to describe professional services?

• A. CPT/HCPCS procedure codes and ICD-10-CM diagnosis codes
• B. DRG codes
• C. SNOMED terms
• D. National Drug Codes

Answer: (A)

Professional services on the CMS-1500 form are described using CPT/HCPCS procedure codes to identify the exact service performed, and ICD-10-CM diagnosis codes to document the underlying condition and justify the service. CPT codes cover the procedures or services, while HCPCS adds codes for items or services not in CPT. The ICD-10-CM diagnosis codes link the service to a medical condition and support medical necessity. DRG codes are used for inpatient hospital billing, not for CMS-1500 professional claims. SNOMED terms are clinical terms used in records rather than standard billing codes on this form, and National Drug Codes identify medications rather than services.