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QUESTION IMAGE

instructions: select the most appropriate response. when unlisted codes…

Question

instructions: select the most appropriate response.
when unlisted codes are reported on a cms - 1500 claim, what is submitted to the payer with the claim to clarify the services rendered?
a. explanation of benefits
b. remittance advice
c. source document
d. claim attachment

Explanation:

Brief Explanations

When unlisted codes are reported on a CMS - 1500 claim, a claim attachment (d) is submitted to the payer. The claim attachment provides additional details and clarifications about the services rendered that the unlisted code represents. An explanation of benefits (a) is what the payer sends to the patient or provider after processing a claim. A remittance advice (b) is also from the payer, detailing payments made. A source document (c) is more of an original record like a patient's medical record but not specifically for clarifying unlisted codes on a claim in the context of what is submitted with the claim.

Answer:

d. claim attachment