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FREE AND STUDY GAMES ABOUT CMS - 1500 BLOCKS
EXAM QUESTIONS
Actual Qs and Ans Expert-Verified Explanation
This Exam contains:
-Guarantee passing score -45 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation
Question 1: BLOCK 6
Answer:
PT'S RELATIONSHIP TO INSURED
Question 2: BLOCK 16
Answer:
Dates Patient Unable to Work in Current Occupation
Question 3: BLOCK 28
Answer:
Total Charge
Question 4: BLOCK 20
Answer:
OUTSIDE LAB?
(check yes or no)
Question 5: BLOCK 27
Answer:
Accept Assignment?
(check off Yes or No)
Question 6: BLOCK 26
Answer:
Patient's Account Number
Question 7: BLOCK 24 H
Answer:
LEAVE BLANK
(says EPSDT Family Plan)
Question 8: BLOCK 24 D
Answer:
Procedures, Services or Supplies (up to 6) and Modifiers (up to 4 each procedure; or a total of 24)
Question 9: BLOCK 11 A-D
Answer:
Insured's Information - Policy/Group Number, Employer/School Name, Insurance Plan/Program Name
11) Policy# 11A) Insured's DOB & Sex 11B) Other claim ID 11C) Insurance Plan Name/Program Name 11D) Is there another health benefit plan?
Question 10: BLOCK 2
Answer:
PT FIRTS NAME, MIDDLE INITIAL, AND LAST
Question 11: BLOCK 22
Answer:
LEAVE BLANK
(resubmission code)
Question 12: BLOCK 14
Answer:
Date of Current - Illness (First Symptom) OR Injury OR Pregnancy (LMP)
Question 13: BLOCK 7
Answer:
INSUREDS ADDRESS, IF THE ADDRESS IS THE SAME AS PT PUT SAME IN BOX
Question 14: BLOCK 17 A-B
Answer:
17) Name of Referring Provider or Other Source
17a) leave blank
17b) ID Number of Referring Physician, NPI - Enter Referring Provider's NPI number.
Question 15: BLOCK1
Answer:
WHERE YOU PUT THE TYPE OF INSURANCE IS APPLICABLE
Question 16: BLOCK 24 C
Answer:
Emergency Indicator
(leave blank)
Question 17: BLOCK 15
Answer:
LEAVE BLANK
Question 18: BLOCK 8
Answer:
LEAVE BLANK
Question 19: BLOCK 24 G
Answer:
# of Days or Units
Question 20: BLOCK 4
Answer:
PRIMARY INSUREDS NAME
Question 21: BLOCK 32 A
Answer:
Service Facility Location Information - Enter the NPI of the facility where the services were rendered.
Question 22: BLOCK 19
Answer:
RESERVED FOR LOCAL USE
(additional claim info)
Question 23: BLOCK 24 E
Answer:
Diagnosis Pointer
Question 24: BLOCK 33 A
Answer:
Billing Provider Info & Phone # (Pay-To, NPI) - Enter the billing provider's NPI.
(leave 33b shaded portion blank)
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