Which CMS-1500 block is required to indicate a worker's compensation claim?

• A. Block 2
• B. Block 5A
• C. Block 13
• D. Block 10a

Answer: (D)

When a claim is for workers’ compensation, you need to flag that status in the part of the form that handles payer and employment information, so the claim goes to the correct WC program rather than a standard health insurer. The designated area for this purpose is the block that captures the employer details and the workers’ compensation claim information. Filling this block correctly ensures the claim is routed to the appropriate workers’ compensation payer and that any required WC-specific data (like the employer and claim number) is included.

Other parts of the form focus on the patient’s demographics, the primary insurer, and the service details. They do not specifically indicate a workers’ compensation claim, so using the dedicated WC block is essential to avoid misrouting or delays. If the patient does have a workers’ comp claim, this block must reflect that status so processing systems recognize and handle the claim under the correct WC guidelines.