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Columns : Claims Today

Revised CMS-1500 Form Implemented

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In August 2013, the Centers for Medicare & Medicaid Services (CMS) approved an updated version of the Health Insurance Claims Form – the CMS-1500 paper claim form (version 02/12) for implementation beginning Jan. 6, 2014. We currently are in a “grace period” in which both the old form (version 08/05) and new form (version 02/12) will be accepted. However, effective April 1, 2014, providers only can submit claims using the new CMS-1500 version 02/12 form.

The National Uniform Claim Committee (NUCC) maintains the CMS-1500 form and instructions. According to the NUCC CMS-1500 webpage1, the revised CMS-1500 form accommodates reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3.

As listed on its site, the NUCC approved the following transition timeline at its in-person meeting in Chicago on Aug. 1, 2013.

  • Jan. 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12).
  • Jan. 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
  • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12).

A crosswalk (change log) between the 1500 Claim Form 08/05 version and the 02/12 version as well as an instruction manual also can be found on the NUCC CMS-1500 webpage.

 

  1. http://nucc.org/

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