CMS 1500 Claim Form Exam Questions and Answers Latest Update 2025/2026
The top portion of the claim form where the insurance company address is entered - Answers
Upper margin
Where the insurance type is marked with an X - Answers Block 1
Qualifier for DOA/Date of present illness block 14 - Answers 431
Qualifier for LMP block 14 - Answers 484
Referring Provider block 17 - Answers DK
Ordering provider block 17 - Answers DQ
Supervising provider block 17 - Answers DK
They are arranged in 8 digit formats MM/DD/YYYY only even though the field on the form says
YY - Answers How dates are arranged for DOB
They can be 6 or 8 digit formats, but be consistent - Answers How dates are arranged for DOS
These codes are found in the CPT manual - Answers Where are POS found?
They're found in CPT and HCPCs manuals - Answers Where are modifiers and their descriptions
found?
10 digit number that recognizes providers with insurance companies; found at
https://npiregistry.cms.hhs.gov/ - Answers NPI: National Provider Number
Tax ID number that the insurance company uses to report money sent to providers for IRS
purposes - Answers EIN: Employer Identification Number
Providers who do not have a business/corporation IRS number have their revenue reported
directly to their personal SS#. - Answers SS: Social Security Number
Medicaid related program for kids and family planning. Enter Y for yes, this was a Medicaid
related kids screening or family planning service - Answers EPSDT: Early & Periodic Screening,
Diagnosis, and Treatment
the healthcare provider who rendered the service; their NPI is listed in 24J of the claim form -
Answers Rendering provider
the healthcare provider who suggested the patient come to have services with the provider we
are billing for; their NPI is listed in 17a of the claim form - Answers Referring provider
the healthcare provider who orders the services listed in the claim; their NPI is listed in 17a of
the claim form - Answers Ordering provider
The top portion of the claim form where the insurance company address is entered - Answers
Upper margin
Where the insurance type is marked with an X - Answers Block 1
Qualifier for DOA/Date of present illness block 14 - Answers 431
Qualifier for LMP block 14 - Answers 484
Referring Provider block 17 - Answers DK
Ordering provider block 17 - Answers DQ
Supervising provider block 17 - Answers DK
They are arranged in 8 digit formats MM/DD/YYYY only even though the field on the form says
YY - Answers How dates are arranged for DOB
They can be 6 or 8 digit formats, but be consistent - Answers How dates are arranged for DOS
These codes are found in the CPT manual - Answers Where are POS found?
They're found in CPT and HCPCs manuals - Answers Where are modifiers and their descriptions
found?
10 digit number that recognizes providers with insurance companies; found at
https://npiregistry.cms.hhs.gov/ - Answers NPI: National Provider Number
Tax ID number that the insurance company uses to report money sent to providers for IRS
purposes - Answers EIN: Employer Identification Number
Providers who do not have a business/corporation IRS number have their revenue reported
directly to their personal SS#. - Answers SS: Social Security Number
Medicaid related program for kids and family planning. Enter Y for yes, this was a Medicaid
related kids screening or family planning service - Answers EPSDT: Early & Periodic Screening,
Diagnosis, and Treatment
the healthcare provider who rendered the service; their NPI is listed in 24J of the claim form -
Answers Rendering provider
the healthcare provider who suggested the patient come to have services with the provider we
are billing for; their NPI is listed in 17a of the claim form - Answers Referring provider
the healthcare provider who orders the services listed in the claim; their NPI is listed in 17a of
the claim form - Answers Ordering provider
