Activity: Using the directions for completing a 1500 claim form

Activity: Using the directions for completing a 1500 claim form in chapter 11 of the textbook, identify the claim errors in figure 11-2 Brittany Bright. There are a total of 3 errors on the claim to be identified. Completed claims and additional instructions on how to complete the 1500 can be found in Chapter 12. Example for reference – Figure 11-1 Chris P. Cream Errors: 1. Box 1 – The x should be in the box labeled Other 2. Box 2 – Name is in the incorrect format – Should be Cream, Chris P 3. Box 21a – Format of ICD-10 incorrect – should be M129 – no punctuation 4. Box 25 – no dashes are used in the number 5. Box 28 – no decimal points are used

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