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Premolar III

Claim form fields

If we are making a prosthetic that is replacing an existing prosthetic, when completing the claim form we have the option to indicate if it is a replacement, the reason for replacement, and the date of prior placement.  Replacement (Y or N) populates in box 43.  Prior date of placement is in box 44.  Where does the "reason for replacement" go?  I don't see it anywhere - not even a field for it.

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Re: Claim form fields


    After searching online for answer on this, I came across this.

   I read through it for the boxes in question, but found no assigned place for it and can only think that it would go in the remarks section in box 35. The only way to be sure though would be to call the insurance company involved and verify that is the place they want the info.