Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingEasy
A medical assistant is preparing to submit a claim for a patient who had an office visit and several laboratory tests performed in-house. Which of the following forms is universally accepted for submitting professional claims to payers?
- AUB-04
- BCMS-1450
- CHCPCS Level III
- DCMS-1500
Show answer & explanationAnswer & explanation
Correct answer: D. CMS-1500
The CMS-1500 form is the standard claim form used by physicians and other non-institutional providers to bill for professional services. It is widely accepted by Medicare, Medicaid, and most commercial insurance carriers.
Why the other options are wrong
- A. The UB-04 form is used by institutional providers like hospitals for billing, not for professional services.
- B. The CMS-1450 is another name for the UB-04 form, used for institutional billing.
- C. HCPCS Level III codes are local codes, not a claim form, and are rarely used anymore.
CMS-1500 Claim Form
A standardized paper claim form used by physicians and other non-institutional providers to bill for professional services.
- Used for professional (physician) services.
- Accepted by Medicare, Medicaid, and most commercial insurers.
- Contains patient, provider, and service information.
Memory trick: CMS-1500: 'C' for Clinic, 'M' for Medical Assistant, 'S' for Services.