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23 Cards in this Set
- Front
- Back
When a patient is seen by his surgeon for postoperative complications, any service provided are
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Included as part of the global surgery and not billed separately.
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According to optical scanning guidelines, the punctuation that is acceptable when it is part of the patient's name is a
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hyphen
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Birth dates are entered as in block 3 of the CMS-1500 claim.
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MM DD YYYY
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The diagnosis code reported in item 1, block 21, of the CMS-1500 claim is the
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first-listed diagnosis
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Items 1-4 in block 21 of the CMS-1500 claim link the listed diagnosis codes to their appropriate procedure/service codes reported in block 24. These items are known as diagnosis
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pointers
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The legal business name of the practice is also called the
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billing entity
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The unique identifier that CMS will assign to providers as part of HIPAA requirements is called the
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NPI
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The maximum number of CPT and/or HCPCS modifiers that can be reported in block 24 of the CMS-1500 claim is
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four
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Block 25 of the CMS-1500 claim required entry of either the provider's social security number or the
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EIN
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Which character is entered in the boxes of block 8 of the CMS-1500 claim to indicate patient status?
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X
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When entering the diagnosis codes in block 21 of the CMS-1500, which is entered instead of the decimal?
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space
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A total charge of $900 would be entered on the CMS-1500 as
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900 00
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What is reported in block 24e of the CMS-1500?
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diagnosis pointer number
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When repoting anesthesia time in block 24g, how must the time be entered?
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units
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Provider services for inpatient medical cases are billed on what basis?
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fee-for-service
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Which prohibits a payer from notifying a provider about payment or rejections on unassigned claims?
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Federal privacy act of 1974
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Medicare conditions of participation require providers to maintain copies of government insurance claims and attachments submitted for what period of time?
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five yeards
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When a patient signs block 13 of the CMS-1500, allowing payment to go directly to the provider, this is known as
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assignment of benefits
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When an X is entered in one or more of the yes boxes in block 10 of the CMS-1500 claim, this may indicate that
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the provider will accept assignment on the claim
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An example of supplemental insurance plan is
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medigap
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to prevent breach of patient confidentiality , the patient must either sign an authorization for release of medical information statement, or
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verbally authorize the practice to submit the claim
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which diagnosis is considered a chronic condition that would always affect patient care?
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diabetes melitius
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in block 24g, unites would be entered based on the following statement: three-view sinus series.
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1
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