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The revised CMS 1500 claim form will soon be required
e-Reports, Nov. 12, 2013
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The Centers for Medicare & Medicaid Services (CMS) completed a revision of the CMS 1500 claim form that will be required for paper Medicare claims in January. Also, expect changes to the electronic format.

The new form will differentiate between ICD-9-CM and ICD-10-CM diagnosis codes and expand possible diagnosis codes up to 12. Also, qualifiers identifying provider roles on Item 17 will include ordering, referring and supervising.

Find instructions for the revised form in Chapter 26 of the Medicare Claims Processing Internet Only Manual (IOM, Pub. 100-04). Here’s a 2014 timeline for implementation:

  • Jan. 6 – Medicare begins accepting paper claims on the revised CMS 1500.
  • Jan. 6 to March 31 – Dual-use period; paper claims accepted on the old form as well as the revised CMS 1500.
  • April 1 – Paper claims accepted only on the revised CMS 1500 claim form (version 02/12).

Find more information here.

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