Exam 11: Essential Cms-1500 Claim Instructions

When entering codes for diagnoses on a CMS-1500 claim, qualified diagnosis codes (e.g., possible, probable) are never reported. Instead, codes for the patient's __________ are entered.

Which occurs when a physician in the community refers a patient to the hospital for observation, bypassing the clinic or emergency department?

When entering a fee in Blocks 24F, 28, or 29, enter __________ in the cents column.

Postoperative complications requiring a return to the operating room for surgery related to the original procedure are billed as an additional procedure, and the additional procedure is linked to __________.

ICD-10-CM diagnosis codes are entered in Block 21 of the CMS-1500 claim. A maximum of __________ ICD-10-CM codes may be entered on a single claim.

The optical scanning process uses a device that converts __________ characters into text that can be viewed by an optical character reader (OCR).

Hospital inpatient charges are reported on the __________ claim.

HIPAA regulations require all payers to accept __________ attachments.

The CMS-1500 paper claim was designed to accommodate optical scanning of __________ claims.

When reporting procedures and services on the CMS-1500, list one procedure per line, starting with line one of Block 24. To report more than six procedures or services for the same date of service, __________.

Diagnosis pointer letters A-L are preprinted in Block 21 of the CMS-1500 claim to allow for entry of __________ codes, and they are reported in Block 24E.

Which of the following health care professionals is permitted to bill a physician when that physician provides direct supervision of procedures/services?

The code reported in Block 21A of the CMS-1500 claim is the major reason the patient was treated by the health care provider. It is called the __________ diagnosis.

Which was developed by the Centers for Medicare and Medicaid Services to assign the unique health care provider and health plan identifiers and to serve as a database from which to extract data?

When a person uses a title such as Sr., Jr., II, or III, __________.

When completing the CMS-1500, enter a __________ for the dollar sign or decimal in all charges or totals and parentheses surrounding the area code in a telephone number.

Provider services for inpatient care are billed on a fee-for-service basis, and service results in a unique and separate charge designated by a __________ or HCPCS level II service/procedure code.

Which is considered a nonphysician practitioner?

Secondary diagnoses codes are entered in Blocks __________ of the CMS-1500 claim.

Diagnoses must be entered in the patient's record to validate __________ of procedures or services billed.