Which Form Locator set contains the fields for Value Codes and Amounts (39 through 41)?

Which Form Locator set contains the fields for Value Codes and Amounts (39 through 41)?

• A. Form Locators 39-41
• B. Form Locator 42
• C. Form Locator 47
• D. Form Locator 49

Answer: (A)

Value codes and their corresponding amounts are kept together in a specific UB-04 Form Locator group, which spans 39 through 41. These locators are designated to capture value codes (which identify special billing situations) and the amounts associated with those codes, potentially for more than one code/amount pair. That grouping is why the correct choice points to Form Locators 39-41. The other locators listed refer to different data elements on the form (not value codes and their amounts), so they don’t fit for this purpose.

Value codes and their corresponding amounts are kept together in a specific UB-04 Form Locator group, which spans 39 through 41. These locators are designated to capture value codes (which identify special billing situations) and the amounts associated with those codes, potentially for more than one code/amount pair. That grouping is why the correct choice points to Form Locators 39-41. The other locators listed refer to different data elements on the form (not value codes and their amounts), so they don’t fit for this purpose.