Health Care Case Study

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Answer: The first section to be filled out on the CMS 1500 form in boxes one through 13 include patient demographic information as well as insurance information. This information is captured to ensure the proper claim is associated with the correct patient. The second section to be filled out on the CMS 1500 form from boxes 14-33 include information specific to the facility the patient was seen at, the diagnosis codes, the provider and other critical pieces of information to show what procedures or care was provided to the patient listed in boxes 1-13. Below is a detailed list of all the boxes and exactly what would be or could be entered into each of them. CMS 1500 Form Box number and descriptors: Block 1 Show all type(s) of health …show more content…

The MA number must appear in this Block regardless of whether or not a recipient has other insurance. Medical Assistance eligibility should be verified on each date of service by calling EVS. EVS is operational 24 hours a day, 365 days a year at the following number: 1-866-710-1447- Required Block 9b RESERVED FOR NUCC USE – No entry required. Block 9c RESERVED FOR NUCC USE – No entry required. Block 9d INSURANCE PLAN OR PROGRAM NAME – Enter the insured’s group name and group number only when there is third party health insurance coverage besides Medicare and Medicaid. – Optional. Block 10a IS PATIENT’S CONDITION RELATED TO - Check “Yes” or “No” to indicate whether employment, auto liability, or other accident involvement applies to one or more of the services described in Item 24, if this information is known. If not known, leave blank. – Optional. Block 10d CLAIM CODES – When billing for abortions or abortion related service, enter the appropriate two-alpha character (AA-AH) condition code from the table below. This field should ONLY BE USED for abortions and abortion related services, otherwise leave blank. AA(a) Abortion Performed due to Rape Code indicates abortion performed due to a rape. AB(a) Abortion Performed due to Incest Code indicates abortion performed due to an incident of incest. AC(a) Abortion Performed due to Serious Fetal Genetic Defect, Deformity, or

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