Medical Claim Forms - Essay Example

            Lines 18, 19, 20, 22, and 23 are the most important lines on the form that is included on the page below, as these particular lines contain the codes.  It is not reasonable, safe, or reliable to expect a billing specialist to remember all of the codes and modifiers that are safe.  Therefore, he or she will need a reference guide for this.  Since these codes and modifiers are updated occasionally, an online reference guide would be a good resource.  One good resource is the website of the Centers for Medicare and Medicaid.

            In the form below, the website for the Centers for Medicare and Medicaid was used to look up the codes.  The diagnosis code for this particular patient matches that of an individual with multiple sclerosis.  The codes that follow the diagnosis code are procedural codes that represent the testing that was done during the office visit of that particular patient.  There could have also been supplying codes included, but no supplies were used in this particular visit that was going to be billed to the insurance company in question.  Had there been supplies used, those would need to be included on the form as well.  The codes were looked up using a search engine on the website, which provided a page listing the codes for musculoskeletal disorders.

X                                                                                             555-55-5555

Patient, Fake                                   07   01  70                X    Patient, Fake

101 Fake St.                                         X                                101 Fake St.

Fictitious                                 TX           X                            Fictitious                               TX

55555                 555 555-5555                                              55555                   555 555-5555 

N/A                                                                                         N/A

N/A                                                                                          07      01  70                          X

N/A                                                                                         N/A

N/A                                                                                        Medicaid

Medicaid                                                                                             X

          Fake Patient                                      08-07-08                        Fake Patient

08  05  08                                                       N/A                 N/A

Dr. Mystery                                 6666                                   N/A

                                                                                                            X

                                                                                                12345

08 05   08 08 05  08              99215                        340            175 00

08 05   08 08 05  08              95868                        340            225 00

08 05   08 08 05  08              95900                        340            217 00

08 05   08 08 05  08              95903                        340            178 00

08 05   08 08 05  08              95904                        340            112 00

555-55-5555          X        55-5555                X                           907   00       907   00          0  00

                                           Handy Clinic                                         Same

Ramona Ouch, MD, 8/7/08      201 Fix Me St.                                       (444) 444-4444

                                                    Fictitious, TX  55555                                4444                           44-4444