Abstract: A healthcare insurance claim processing system and method generates a first set of data fields for display in a healthcare claim form. The first set includes requests for patient billing and medical information, and a request for a medical procedure code. The medical procedure code associated with a medical diagnosis of the patient is entered for at least one field of the first set of data fields. A second set of data fields is generated in accordance with the medical procedure code for display in the healthcare claim form. The second set of data fields includes requests for medical diagnostic information of the patient to assist in diagnosing a medical condition of the patient. The healthcare claim form with information from the first and second sets of data fields is submitted to a payer for payment of the health insurance claim associated with the medical condition of the patient.