Reminder: CMS-1500 Form (Version 08/05) Expires March 31

The timeline that CMS provided to allow providers to transition from the old version of the CMS-1500 claim form (08/05) is coming to an end. Effective April 1, claims will only be accepted if submitted on the new version of the claim form identified by the date 02/12 in the lower right hand corner. The CMS-1500 Form has been revised to give providers the ability to indicate whether they are using the International Classification of Diseases, ninth edition, Clinical Modification (ICD-9-CM) codes or its successor, the ICD-10-CM and allows for additional diagnostic codes to be reported. Additional changes were made to item numbers 14, 15 and 17, which now have qualifiers to identify provider roles such as ordering, referring or supervising. ACA has prepared a 1500 Claim Form Fact Sheet, which is free to members, to assist your clinic in making the needed changes. Further information from CMS on this topic can be found here.

Additionally, the National Uniform Claim Committee (NUCC) has developed a 1500 Reference Instruction Manual detailing how to complete the claim form. The purpose of this manual is to help standardize nationally the manner in which the form is being completed. The current version of the instructions (v 9.0) was released in July 2013: Version 9.0 7/13


Share this post: