Effective Date:  April 1, 2014

More ICD-10 changes...

Because the current version of the CMS 1500 claim form (version 08/05) cannot accommodate the changes associated with ICD-10 codes, the National Uniform Claim Committee (NUCC) revised the CMS 1500 claim form, and in 2013, the revised form was approved by the White House Office of Management.

Effective April 1, 2014, all paper claims, regardless of date of service, must be submitted on the revised CMS 1500 claim form, version 02/12.  After March 31, 2014, neither HNS nor payors (including Medicare and Medicaid) will accept claims submitted on the previous CMS 1500 claim form (version 08/05).

The revised CMS 1500 claim form must be used for ALL claims submitted as paper claims, including all secondary claims, corrected claims and claims with attachments.

While there are numerous changes to the new CMS 1500 claim form, the most notable are:

1. 1. An update to Box 21 (Diagnosis Codes) which has been expanded to accommodate 12 diagnosis codes (instead of 4);
   2. The revised form uses letters, instead of numbers, as diagnosis code pointers (A-L instead of 1-4); and
      
   3. The new form includes a new one character field, the "ICD Indicator", which serves as a place to indicate whether the codes you are billing are ICD-9 or ICD-10 codes.  You must enter a 9 if the claim includes ICD-9 codes and a 0 if the claim includes ICD-10 codes.
      

Click on the links below to learn more about the revised CMS 1500 and make sure you have an adequate supply of the revised claim forms prior to the April 1, 2014 effective date.

Image of Revised CMS 1500 (02/12)

Instructions for Use of the Revised CMS 1500

Changes at a Glance

List of All Changes to the Revised CMS 1500