Jeopardy Template

Coding

100

True or False

You can open a coding request if the claim is force extracted. 

Yes, if the force extraction has nothing to do with your denial. 

200

What Note type is associated with "Invalid/Missing Modifier" Coding QUIC

Note Type 408

300

True or False

We have to go to coding for an unspecified Diagnosis Denial when the denied CPT has  a mod appended. 

No, we can search for the appropriate DX in Codify that supports the specified dx and the modifier being billed. 

400

Medical records were requested by the carrier and you receive the denial "Procedure code invalid" on the next touch.  

Do you submit an appeal or open a coding Quic?

Open coding QUIC 413 as medical records likely do not support the CPT being billed. 

500

This note type is used for Invalid Primary DX

Note Type 422

Bundling

100

This modifier should be appended to an E & M code that denies bundled. 

Modifier 25

200

What FL do we use if the CPT has no modifier appended to it but all codes are allowed as billed. 

Form Letter 356

300

True or False 

We don't have to include the CCC proof with the bundling appeal?

False, we must include the CCC proof with all Bundling Appeals to show the CPTS are allowed as billed. 

400

This note type is used when we receive a global denial and must go to coding. 

Note type 406

500

This form letter must be used when submitting an appeal for a CPT with modifier 59 appended to it.

Form letter 375

Note Type

100

This Note Type is to be used if we are flipping the FSC and submitting the claim to a new insurance 

Note type 108

200

This note type is to be used when submitting a 3rd level appeal. 

Note Type 500

300

This note type is used to open a front end request for an Auth 

Note type 302

400

This note type should be used when escalating a claim to the supervisors worklist

Note type 508

500

This note type should be used when the provider is in delegation and you must transfer it to Internal cred

Note type 515

QOPI

100

Where can you locate "the crosswalk" 

Desk Reference Guide in QOPI

200

This Pay Code is used to adjust off experimental/Ivestigational

Pay code 8110

300

True or False 

After 8/18/2025 the Timely filing limit for Anthem is 1 year for claim submission and charge corrections. 

False 

After 8/1/2025 it goes to 180 days 

400

True or False

You may use pay code 8131 without approval from a senior rep or supervisor. 

False

You must get approval before adjusting off with paycode 8131. 

500

True or False 

You don't have to send the HCFA Via Certified Mail when dropping it to paper. 

False

HCFA must always be ssent via certified mail so it can be tracked