January 6th, 2016
By: Scott Kraft (Feb/28/2014)
CMS-1500 form revised to fit more diagnosis codes, less patient demographic information
It doesn’t get used nearly as much as it used to, but there is a new CMS-1500 claim form that has been revised slightly to fit more diagnosis codes and to facilitate the transition to the ICD-10-CM coding system set for Oct. 1, 2014. The new CMS-1500 form will also collect a little less patient information.
While most claims are now filed electronically, changes to the paper CMS-1500 often result in changes to the information collected in an electronic claims filing.
Here’s what you need to know, according to CMS transmittal 2842 to the Medicare Claims Processing Manual:
- The new CMS-1500 form is recognized by the date of (02/12) in the lower right corner, replacing the (08/05) used on the current form.
- CMS will permit the use of either CMS-1500 form for the first quarter of 2014, but claims received on or after April 1, 2014, must be on the new (02/12) form.
- The new CMS-1500 will hold as many as 12 diagnosis codes. The current form holds only four, though electronic claims must accept at least eight.
- There is a new space for an indicator in the diagnosis code area. CMS instructs you to use the indicator 0 when reporting ICD-9 codes and 9 when reporting ICD-10 codes.
- There is space for three new modifier-type codes to use in Box 17. Use DN to indicate a referring provider, DK for an ordering provider and DQ for a supervising provider. When filing a paper claim form, you would need an additional claim form when there are multiple ordering, referring or supervising providers. An electronic claim can likely handle this information.
- You no longer would report the patient’s marital, employment or student status in Box 8.