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On a claim form, the date on which an accident occurred is reported using:

a. FL 12 (Patient Address)
b. FL 24 (Dates of Service)
c. FL 14 (Date of Current Illness, Injury, or Pregnancy)
d. FL 31 (Occurrence Code and Date)

1 Answer

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Final answer:

The accident date is correctly reported using FL 14 (Date of Current Illness, Injury, or Pregnancy) on a medical claim form, which is crucial for insurance and treatment timelines.

Step-by-step explanation:

The date on which an accident occurred is reported on a claim form using FL 14 (Date of Current Illness, Injury, or Pregnancy). This field is designed to capture the specific date when the illness, injury, or pregnancy began or manifested itself.

It's important for processing medical claims as it helps establish timelines for insurance coverage and treatment durations. The form locator (FL) numbers correspond to specific fields on standardized medical forms such as the CMS-1500 and the UB-04, which are used in the healthcare industry for billing medical services.

User Thavamani Kasi
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