CMS 1500
A Superbill is
What is an invoice to document the services ordered or rendered during a patient visit, often referred to as an invoice of services and a tool to eliminate the need for transcribing medical record notes from a patient chart
What is the appropriate bill frequency code for replacement of a prior claim when resubmitting a claim
What is code 7, entered in item 22
What is the name of the document that indicates what medical treatments and/or services were paid for on behalf of a covered individual?
What is the Explanation of Benefits
Which of the following are exempt from the requirements in #4 (500 question)
What are psychiatric, children's, long-term care and any hospital outside the 50 states, DC and Puerto Rico
Unprocessable
What is considered incomplete or invalid due to missing claim form data elements
Which of the following is NOT a true statement about the CMS 1500 form
What is one claim can report up to 8 lines of service
What is the place of service code for a birthing center? Where would you enter this code on the 1500 claim form?
What is code 25, enetered in item 24b
The deadline to file a Medicare claim for services rendered on September 23, 2016 is
What is September 23, 2017
What are some ways that electronic claims can be transferred
What is Manual Entry, PC download, tape transfer and CPU to CPU
Non-standard
Has extraneous attachments in lieu of data entered correctly in the claim form
When completing the CMS 1500 form, there are special restrictions (no adhesive-backed label, printing, correction fluid and so on) regarding the
What is the Top Right margin of the form
Which items indicates that the provider is requesting to be paid for the services rendered?
What is Item 33, the provider's/supplier's billing name, address, ZIP code ad telephone number
Which of the following is NOT an exception to the mandatory filing rule?
What is the provider attempted to obtain a signed ABN but the beneficiary refused to sign it
Incomplete
What is missing required infromation
Which of the following is NOT one of the OIG's seven elements?
Written policies and procedures
Pre-employment background checks
Effective training and education
Responding to offenses and developing corrective action plans
What is Pre-employment background checks
Where would you enter the FECA number on a 1500 claim form for a patient claiming work-related conditions
What is Item 11
The date of birth must be entered as 8 digits (MM/DD/CCYY). Other dates can be entered in either 6-digits (MM/DD/YY) or 8-digits (MM/DD/CCYY) format, but you cannot intermix formats on the same claim form.
True or False
What is True
When timely-filing limits are not met
Clean
What is: will pass CWF edits, is processed electronically and does not require further contact or evidence
What is the qualifier for Provider Taxonomy for the 1500 claim form
What is ZZ (the qualifier in the 5010a1 for Provider Taxonomy is PXC, but ZZ will remain the qualifier for the 1500 claim form)
The Medicare _ requires all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within _ days prior to the hospital admission to be bundled with the inpatient services for Medicare billing.
What is the 3-day rule and 3
Invalid
What is contains complete and necessary information, but the information is illogical or incorrect