CMS has recently announced that they will be implementing an updated CMS 1500 form for all paper claims filed to Medicare. The revised CMS 1500 form (version 02/12) will have the following additional functionalities:
• Indicators for differentiating between ICD-9-CM and ICD-10-CM diagnosis codes.
• Expansion of the number of possible diagnosis codes to 12.
• Qualifiers to identify the following provider roles (on item 17)
Medicare has established the following tentative timeline to phase in the use of CMS 1500 form (version 02/12):
January 6, 2014: Medicare begins receiving and processing paper claims submitted on the revised CMS 1500 claim form (version 02/12).
January 6 through March 31, 2014: Dual use period during which Medicare continues to receive and process paper claims submitted on the old CMS 1500 claim form (version 08/05).
April 1, 2014: Medicare receives and processes paper claims submitted only on the revised CMS 1500 claim form (version 02/12).
In addition, CMS is currently updating the Medicare Claims Processing Manual with instructions about completing the revised forms.
Please see the full notice in the following MLN Connects Newsletter:
In addition, the new version of the CMS 1500 form can be viewed at the following link:
In preparation to begin using the revised forms, SHP encourages our clients to work with their EDI vendors/clearinghouses/billing software companies to ensure compliance with the new CMS 1500 forms.