Questions: The process of linking procedure/service and condition codes on a CMS-1500 claim justifies a. coding. b. hold harmless. c. medical necessity. d. scope of practice.

The answer is c: medical necessity.

Explanation for each option:

a. Coding: This refers to the process of assigning standardized codes to medical procedures and diagnoses. While coding is an essential part of preparing a CMS-1500 claim, linking procedure/service and condition codes specifically justifies the medical necessity of the services provided, rather than the coding itself.

b. Hold harmless: This is a legal term that refers to agreements where one party agrees not to hold the other party responsible for any loss, damage, or legal liability. It is not directly related to the process of linking procedure/service and condition codes on a CMS-1500 claim.

c. Medical necessity: This is the justification for why a particular medical service or procedure is reasonable, necessary, and/or appropriate based on evidence-based clinical standards of care. Linking procedure/service and condition codes on a CMS-1500 claim is done to demonstrate that the services provided were medically necessary.

d. Scope of practice: This refers to the activities that professionals are permitted to undertake in keeping with the terms of their professional license. While important, it is not directly related to the process of linking procedure/service and condition codes on a CMS-1500 claim.

In summary, the process of linking procedure/service and condition codes on a CMS-1500 claim is primarily to justify medical necessity.