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Updates from the Centers for Medicare & Medicaid Services
e-Reports, Aug. 5, 2013
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Get ready: Revised CMS 1500 claim form is on its way

The Centers for Medicare & Medicaid Services (CMS) has advised that the CMS 1500 claim form, the required format for submitting Medicare claims on paper, has been revised and approved. You should expect changes to the electronic format as well.

The new form, accepted beginning in January, will feature:

  • Indicators for differentiating between ICD-9-CM and ICD-10-CM diagnosis codes
  • Expansion of the number of possible diagnosis codes up to 12
  • Qualifiers to identify provider roles on Item 17 to include ordering, referring and supervising

Chapter 26 of the Medicare Claims Processing Internet Only Manual (IOM, Pub. 100-04) will have instructions about how to complete the revised form. It will be posted on the CMS website when available.

Although subject to change, Medicare plans to implement the new form under the following timeline:

  • Jan. 6, 2014 – Medicare begins accepting and processing paper claims submitted on the revised CMS 1500 claim form.
  • Jan. 6 through March 31, 2014 – Medicare offers a dual-use period when it continues to accept and process paper claims on the old CMS 1500 form as well as the revised form.
  • April 1, 2014 – Medicare accepts and processes paper claims only on the revised CMS 1500 claim form(version 02/12).

Continue reading ISMA Reports for additional information as it becomes available.


Now is the time to comment on two key proposed rules from CMS 

The Centers for Medicare & Medicaid Services (CMS) released the Proposed Physician Fee Schedule rule for 2014. Find the rule here.

CMS highlights changes to the following issues: Physician Quality Reporting System, Electronic Health Record Incentive Program, Physician Compare, Shared Savings Program, Value-Based Payment Modifier, Complex Chronic Care Management Services, Telehealth Services, Practice Expense Geographic Adjustment, Medicare Economic Index, Misvalued Codes, and the Application of Therapy Caps to Critical Access Hospitals.

In addition, CMS published the 2014 Hospital Outpatient Department and Ambulatory Surgical Centers proposed rule, available here.

If you’d like to submit comments, you must do so by Sept. 6. The proposed regulations can be found in the July 19 Federal Register.

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