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New 1500 Claim Form Revised to Accommodate ICD-9 or ICD-10 Codes

Written by  Published in Billing & Coding Tips
New 1500 Claim Form New 1500 Claim Form

The new 1500 form or “CMS 1500” or to many the “HCFA 1500” has received an update and is officially designated as “version 02/12”.

In the summer of 2013, the National Uniform Claim Committee (NUCC) announced the approval of the new “version 02/12 1500 Health Insurance Claim Form that accommodates the reporting needs for ICD-10 that will be implemented October 1, 2014.  The NUCC is an organization chaired by American Medical Association (AMA) with the Centers for Medicare and Medicaid Services (CMS) as a critical partner.

The  Five Most Frequently Asked Questions Answered about the New 1500 Claim Form


Why was the 1500 clam form changed?

October 1, 2014 will be the biggest change in Decades when diagnosis codes will go from ICD-9 to ICD-10.  The 1500 Claim form needed to be revised to accommodate the reporting needs for ICD-10 (no 3-7 characters) compared to ICD-9 (3-5 digits). The 1500 form also must align with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3. Click Here for Claim Form Map from NUCC website 

What are the changes to the form?

There are two significant changes to accomodate the transition and implementation of ICD-10

  1. There is now an indicator in Item Number 21 to identify the version of the diagnosis code set being reported either ICD-9 or ICD-10
  2. Item Number 21 also now has additional lines. The number of diagnosis codes that can be reported has been increased to 12 diagnosis from
  3. The NUCC website under “1500 Claim Form” posted a change log with all of the changes to the 1500 claim form. Read here for a full change log  

What is the symbol at the top of the 1500 Claim Form?

The symbol is a “QR” code or Quick Response code. With the necessary app and a smartphone, you can take a picture “scan” a “QR” code.

When do I need to use the 1500 Claim Form?

    • Please see below approved timeline:
      • January 6, 2014:      Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12)
      • January 6 thru March 31, 2014:  Dual use period version 08/05 and  version 02/12
      • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12)
    • Click here for instruction manual

How do I access the new claim form on my practice management medical billing software program?

Most medical billing software programs will require an update.  For example, if you use Medisoft, only Medisoft Version 19 is the ICD-10 compliant medical billing software program.  Contact us to update your Medisoft with the new 1500 Claim Form.  Using Not sure if your program is ready for ICD-10. Contact us for Free Consultation and we will provide you with guidance on some of the best upgrade options.  See a Sample Claim Form 

Hot Links:
  1. Claim Form Map from NUCC Website
  2. Changes To The 1500 Form
  3. Instruction Manual
  4. Sample Claim Form

Our expert consultants are certified and credentialed medical billers & coders + we belong to the elite AHIMA ICD-10 Trainer Ambassadors. We gladly offer your practice a free consultation to provide you with guidance on some of the best options to ensuring your medical billing and coding is accurate and compliant with ICD-10. Contact Us Today

Read 2336 times Last modified on Thursday, 30 January 2014 12:54
Vanessa Best

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Website: www.precisionhcc.com/blog
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