MEDICAL BILLING AND CODING
CHAPTER 7 QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
CMS 100 - - ANSWER paper claim submitted to TPP for reinbursement ( paper claim )
HIPPA x12 837 - - ANSWER electronic form used to send a claim ( HIPPA 837 P claim (electronic)
HIPPA requires electronic transmission of claims by all providers with _________ employees. - ANSWER
10 or more
National Uniform Claim Commitee (NUCC) - - ANSWER organization responsible for claim content
CMS - 1500 (02/12) -revised- - ANSWER current paper claim approved by the NUCC
5010 version - - ANSWER new format for the EDI transactions (data exchange electronic)
The CMS - 1500 claim has a _________________________________ and _____ item numbers (INs) -
ANSWER carrier block and 33 item numbers
Carrier Block - - ANSWER data entry area in the upper right of the CMS - 1500
Condition code - - ANSWER two digit numeric or alphanumeric codes used to report a special condition
or unique circumstance.
The upper portion of the CMS - 1500 claim form ( ITEM Numbers 1-13) : - ANSWER lists demographic
information about the patient and specific information about the patients insurance coverage.
Insurance is entered based on - ANSWER the patient information form, insurance card, and payer
verification .
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