Chapter 5: Advanced CMS-1500 Claim Requirements and Situational Billing Rules

This chapter provides an in-depth look at the CMS-1500 claim form and the rules that govern its use in advanced billing situations. You’ll learn how each section of the form contributes to claim accuracy, how situational rules affect billing, and how errors on the CMS-1500 lead to denials or delays. Practice materials are included to reinforce real-world application.