decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Medicare_Claims_Processing_Manual / Chapter_26 / 10.4
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Article Overview
This Medicare Claims Processing Manual section covers how to complete the provider-of-service and supplier information fields on the CMS-1500 claim form. It is aimed at billing staff, providers, suppliers, and claims administrators who need a current overview of the data elements, identifiers, and supporting information commonly reported in items 14 through 33. The article addresses broad claim-submission topics such as date formats, ordering/referring information, diagnosis reporting, place of service, service location, provider signatures, and related administrative entries.
Why This Topic Matters
Accurate completion of these claim fields affects whether Medicare claims can be processed correctly and whether supporting information is present when required. Understanding the scope of this section helps billing teams identify which claim elements are relevant to their workflow and compliance processes.
Article Sections
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Items 14-16
Covers date fields and employment-related information reported in the early provider and supplier portion of the claim form.
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Item 17
Discusses ordering and referring physician information, related identifiers, and circumstances involving multiple physicians or surrogate identifiers.
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Item 17a
Addresses the entry of the assigned identifier for the referring or ordering physician and special reporting situations.
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Item 18
Explains a date field associated with services furnished after or because of a related hospitalization.
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Item 19
Covers additional date and narrative information used by certain therapists, chiropractors, and other claim scenarios.
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Items 20-23
Summarizes reporting requirements for purchased diagnostic tests, diagnosis entries, authorization numbers, and other administrative identifiers.
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Items 24A-24K
Describes line-item claim reporting for dates of service, place of service, procedure coding, diagnosis pointers, charges, units, and performing provider identifiers.
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Items 25-33
Covers provider or supplier tax information, account numbers, assignment indicators, total charges, payment amounts, signatures, service location details, and billing information.
What You Will Learn
- Which CMS-1500 fields are addressed in this Medicare manual section
- What categories of dates, identifiers, and claim details are reported in items 14 through 33
- How the section organizes provider, supplier, facility, and service-location information
- What broad administrative data elements are associated with Medicare claim submission
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Healthcare providers
- Supplier billing departments
- Claims administrators
Codes Discussed
Modifiers Discussed
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