EOB Reason Codes
If the policy does have a Wellness rider, but does not have Best Wellness ride what reason code do you use to deny the dental cleaning coverage?
375
How do you search for Add Clauses in the Case Overview screen?
127
What are the 2 common symptoms of Parvo Viral infection? (Name at least 1)
1. Vomiting
2. Diarrhea/Bloody Diarrhea
What is the appropriate med cod for a claim with a dental procedure to repair an “underbite”?
Malocclusion
Which of the following scenarios do NOT apply towards the repetitive activity warning? Select ALL:
Rock consumption, Chicken bone consumption, Food Bloat, Food wrapper consumption, Human medication consumption, Hairballs, GI upset from rawhide
Chicken bone consumption
Food Bloat
Hairballs
GI upset from rawhide
The condition being claimed is related to repetitive inappropriate chewing behavior and was present prior to the Policy Effective Date or expiration of the Waiting Period and is not part of policy coverage, which reason code do you use for this?
360
How do you search for First Level Appeal in the Case Overview screen?
76
What are the 3 common signs/symptoms of hyperthyroidism in dogs. (Name at least 2)
1. Heavy and rapid breathing
2. Increased Appetite
3. Excessive Thirst
What condition is characterized by failure of the outer layer of a pet’s tooth to develop properly?
Enamel Hypoplasia
Pet is treated for MRSA. What is the correct med code?
Skin/Ear Infection
Cruciate Ligament Events are not considered a covered Accidental Injury. Which reason code is used for this?
399
How do you search for Contact Policyholder in the Case Overview screen?
171
What are the 4 common signs or symptom of Brachycephalic Syndrome (BAS) ? (Name at least 3)
1. Stenotic nares
2. Elongated soft palate
3. Everted laryngeal saccules
4. Hypoplastic trachea
What does the acronym COHAT stands for? And what is that for?
Comprehensive Oral Health Assessment and Treatment (COHAT)- dental prophylaxis
Pet is diagnosed with Cryptosporidiosis. What is the correct med code?
Intestinal Parasites
This condition incurred as a result of invasion, war, insurrection, rebellion, revolution, military or usurped power, or by operation of armed forces and is not part of policy coverage. Which reason code do you use for this?
205
How do you search for Internal Review in the Case Overview screen?
165
What are the 5 common signs or symptom of Horner's Syndrome? (Name at least 4)
1. Elevated Nictitans,
2. Enophthalmos,
3. Ptosis,
4. Facial Anhidrosis
5. Miosis
What is the appropriate med code for a claim that includes an extraction of tooth #504?
Deciduous Teeth
Pet is diagnosed with Patent Ductus Arteriosus? What is the correct med code?
Cardiac Defect
Insurance fraud unfairly increases premiums for all policyholders. If any policyholder provides false, misleading, and/or dishonest information, we may not pay the claim, may void that policy, and may be required by law to report it to governmental authorities.Which reason code do you use when denying these claims?
402
How do you search for the Policy Declaration in the Case Overview screen?
100
What are the 6 common signs/symptoms of Hepatic Microvascular Dysplasia? (Name at least 5)
1. Hepatopathy,
2. Behavioral Changes,
3. Seizures,
4. Polydipsia/Polyuria,
5. Ataxia,
6. Head Pressing.
How many stages of periodontal disease are there? Which stage(s) is/are reversable with treatment?
4 stages. Stage 1 is only stage reversable with treatment
Pet is diagnosed with Imperforate Lacrimal Punctum. What is the correct med code?
Congenital Condition