Question

Which of the following is not a common reason for a claim not to pass the clean claim requirements?

A. incorrect dates of service
B. incorrect patient ID number
C. incorrect provider address
D. invalid CPT or ICD-9-CM codes

Answer 1

Incorrect provider address is generally not a common reason for a claim to fail clean claim requirements. Common reasons include incorrect dates of service, incorrect patient ID numbers, and invalid CPT or ICD-9-CM codes.

Step-by-step explanation:

The question asks which of the listed options is not a common reason for a claim to fail the clean claim requirements. Among the options provided, incorrect provider address is typically not a standard clean claim requirement in medical billing. Clean claim requirements commonly include correct dates of service, correct patient ID numbers, and valid CPT (Current Procedural Terminology) or ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. These elements are essential for the claim to be processed efficiently and to avoid denial by the insurer.

On the other hand, while the provider's address is important information, it is usually not a cause for claim rejection. Typically, errors such as incorrect dates of service, incorrect patient ID numbers, or invalid diagnostic and procedural codes are more common reasons for a claim being rejected or denied as these directly impact the eligibility and services pertaining to the claim.