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hcr220 college

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I have done my cms 1500 form but I want to make sure that I did it correctly.

Here it goes:

i tried to post it but it will not allow

  • hcr220 college -

    If you tried to copy and paste something (especially if it’s a numbered or bulleted list), it did not work. You’ll need to type it in by hand.

  • hcr220 college -

    is there an email that I can post an attachment?

  • hcr220 college -

    No, you will need to type it, as I said above.

  • hcr220 college -


    The only way we can see it is if you type it here.

    Also -- it's doubtful if any of our Jiskha tutors will be able help you with the "cms 1500 form."

  • hcr220 college -

    This is a cms 1500 form.

    Part One:
    Resources: Appendix A, Appendix C, and Table 8.3 on pp. 258–259 of Medical Insurance
    Refer to Table 8.3 on pp. 258–259 of your text to complete the CMS-1500 form, located in Appendix C, according to the following case study:
    A 67-year-old Medicare patient presents to the office, exhibiting symptoms of HIV infection. After detailed examination, symptoms are determined to be advanced AIDS with manifestation of Kaposi’s sarcoma and other opportunistic infections.
    Name: James Brown
    Account Number: 080811
    Insurer: Medicare
    Policy Number: 1098765
    ID number: 12345678910
    DOB: 02/01/1940
    Gender: Male
    Insured: James Brown
    Address: 1600 Pennsylvania Ave.
    Wash. D.C. 60000
    Marital Status: Widowed
    Patient’s Employer: Retired
    Nature of Condition: HIV, AIDS, Kaposi’s sarcoma
    Date of Illness: 06/01/2007
    Referring Physician: Thomas Glassman, M.D.
    Physician ID: 1080808080
    Federal Tax ID: 5551116679
    Dates of Service: 06/01/2007, 06/15/2007, 07/07/2007, 08/01/2007
    Procedure: Detailed examination, screening blood panel, pathology services
    Patient Signature
    Include ICD (categories only), CPT, HCPCS, and insurance information.
    If you believe there is insufficient information provided to fill a required field with data, indicate this by typing N/A.
    The answers that I need to make sure I have correct are 21. 1. V08 2. O42 3. 176.9

    24. The part D. 1. 99214 2. 80050 3. 80502 and the last one is N/A I just wanted to make sure that I had these correct.

  • hcr220 college -

    Thank you.

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