The most likely outcome of an insurance claim submitted with a diagnosis code of a sore throat and a treatment code indicating a cast for a broken leg would be ________.
A. coverage at 100 percent for both the sore throat and the broken leg
B. the patient may have to pay a coinsurance after the deductible is met
C. denied because the treatment was not medically necessary based on the diagnosis
D. the fee for service would be applied toward the patient's deductible
E. a reprimand to the physician for not treating the sore throat
Answer: C
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Indicate whether the statement is true or false.
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Fill in the blank(s) with correct word