A(n) ________ authorizes the insurance company to send payments directly to the physician.

Pre-op diagnosis: retinal detachment. Post-op diagnosis: left eye, retinal detachment with giant retinal tear. Procedure: laser repair of detachment and tear. The diagnosis code for this case is ____________________.

Fill in the blank(s) with the appropriate word(s).

How many spaces should be left above the signature block to allow for the signature?

A. One B. Five C. Two D. Six to seven E. Three to four