Use CPB Chapter 11_Case 1.pdf to answer questions 1 & 2.
After review of the information provided, are there any errors on the claim form? If so, which elements
are incorrect?
I. The provider must accept assignment
II. Provider name conflict
III. Medicare ID number is missing information
IV. Medicaid ID number is missing information
V. Medicare ID number in the wrong field
VI. Medicaid ID number in the wrong field
VII. Ordering provider name and NPI
VIII. Place of service code
IX. Diagnosis code(s)
X. Diagnosis pointer(s)
A. I, V, VI, and X
B. I, VI, IX, and X
C. III, IV, VIII, and IX
D. There are no errors on this claim. - correct answer B. I, VI, IX, and X
Response Feedback:
When providers provide physician services to individuals dully entitled to Medicare and Medicaid, they
are required to accept assignment. The patient's Medicaid number should be listed in item 10d. For
Medicare, only one diagnosis pointer is entered per line item. Apnea NOS is not mentioned in the
medical record.
, Use CPB Chapter 11_Case 1.pdf to answer the following question.
What should be done to correct this claim?
I. Correct assignment on the claim.
II. Correct primary insurance information on the claim.
III. Correct secondary insurance information on the claim.
IV. Correct the provider information on the claim.
V. Correct the diagnosis on the claim.
VI. Correct the diagnosis pointer(s) on the claim.
A. III and IV
B. I, III, V, and VI
C. I - VI
D. None of the above. - correct answer B. I, III, V, and VI
Response Feedback:
When providers provide physician services to individuals dully entitled to Medicare and Medicaid, they
are required to accept assignment. The patient's Medicaid number should be listed in item 10d. For
Medicare, only one diagnosis pointer is entered per line item. Apnea NOS is not mentioned in the
medical record.
Use CPB Chapter 11 Case 2.pdf to answer questions 3 and 4.
After review of the information provided, are there any errors on the claim form? If so, which elements
are incorrect?
I. Patient name
II. Primary insurance ID number