A claim can be denied or rejected for which of the following reasons?

Prepare for the Certified Billing and Coding Specialist Exam. Improve your skills with multiple choice questions; each question comes with hints and explanations. Get confident for your exam!

The essence of the question focuses on determining which option represents a valid reason for a claim being denied or rejected.

In the context of medical billing, claims must meet specific requirements for successful processing. Block 24D is utilized to provide the procedure codes, not diagnosis codes. When diagnosis codes are incorrectly placed in Block 24D instead of Block 21, it can lead to confusion and misinterpretation of the services rendered. This misclassification can certainly result in rejection or denial, as the insurance company relies on precise coding to understand the medical necessity and appropriate reimbursement.

In contrast, incorrect patient demographics, missing provider signatures, and unverified insurance details relate directly to issues that could also cause a claim to be denied or rejected. However, Block 24D specifically being utilized incorrectly for diagnosis codes is a distinctive coding error that directly affects the claim's evaluation and processing.

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