What is a condition code on 1500?

Background Information. Currently, Condition Codes are designed to allow the collection of information related to the patient, particular services, service venue and billing parameters which impact the processing of an Institutional claim.

What goes in box 33b on a CMS 1500?

What is it? Box 33b is used to indicate a payer-assigned identifier of the Billing Provider. Some payers require the provider’s taxonomy code be listed in Box 33b.

What is the proper format for entering a patient’s name on a CMS 1500?

15 Cards in this Set

HIPAA privacy standards require providers to notify patients about their right to	Privacy
Which is the proper format for entering the name of the provider in block 33 of the CMS-1500 claim?	Howard Hurtz MD
Which is issued by the CMS to individual provider and healthcare institutions?	NPI

What loop and segment is Box 19?

CMS-1500 Claim Form Crosswalk to EMC Loops and Segments

CMS-1500 Form Item	CMS-1500	EMC ANSI 837 Loop
19	Reserved for Local Use (Commentary and Narrative)	2300
20	Outside Lab Charges	2400
21	Diagnosis or Nature of Illness or Injury	2300
21	ICD Indicator BK – ICD-9 ABK –	2300

What does the box 13 in CMS-1500 form represent?

Box 13 is the “authorization of payment of medical benefits to the provider of service.” If this box is completed, the patient is indicating that they want any payments for the services being billed to be sent directly to the provider.

What are six items needed to reference when completing the CMS 1500?

insured’s ID number.

patient full name.

patient date of birth and gender.

insured’s name.

patient’s address and telephone number.

patient relationship to insured.

insured’s address and phone number.

secondary insurance name.

Which item on the CMS 1500 claim form contain information regarding Medigap?

Which Item on the CMS-1500 claim form contain information regarding Medigap? Item 9—Enter SAME if the patient is the Medigap policyholder. If not, enter the policyholder’s last name, first name, and middle initial separated by commas.

What is the electronic version of the CMS-1500?

837
Form CMS-1500 is the standard paper claim form used to bill an insurance for rendered services and supplies. It provides information about the client, their corresponding insurance policy, and their diagnosis and treatment. Additionally, most insurances allow you to send an electronic version, called an 837 file.

What is a Form 837?

So, what is an 837 file? Basically, it’s an electronic file that contains information about a patient claims. This form is submitted to a clearinghouse or insurance company instead of a paper claim. Claim information includes the following data for one encounter between a provider and a patient: A patient description.