Reminder: CMS-1500 Paper Claim Form (Version 02/12)

February 17, 2014

Previous articles have referenced the transition from the previous version of the paper CMS-1500 claim form (08/05) to the revised version (02/12). As a reminder, the transition timeline, which aligns with Medicare’s timeline, is as follows:

  • Jan. 6, 2014 through March 31, 2014 — Dual-use period during which payers continue to receive and process paper claims submitted on the old CMS-1500 claim form (version 08/05), as well as claims submitted on the revised CMS-1500 claim form (version 02/12).
  • April 1, 2014 — Payers receive and process only those claims that are submitted on the revised CMS-1500 claim form (version 02/12). As mandated by the Centers for Medicare & Medicaid Services (CMS), claims submitted on the old form (version 08/05) will no longer be accepted.

What’s different?
If you’ve submitted claims on the revised form (version 02/12) during the dual-use period, you may have noticed that Field 21 now requires users to specify whether they are using ICD-9 or ICD-10 diagnoses codes. Additionally, eight diagnosis codes have been added on the revised form. There are other minor changes as well. If you use a practice management system, billing service or clearinghouse, it’s important to check with your vendor(s) to ensure they are aware and can accommodate any changes.

Don’t Forget to Recycle...
As noted above, the previous version of the CMS-1500 claim form (08/05) will be discontinued as of April 1, 2014. This means you should discard or recycle any unused forms as of this date. For more information on the revised CMS-1500 claim form (version 02/12) such as specific changes, technical specifications and how to order a new supply of printed forms, visit the National Uniform Claim Committee (NUCC) website at .

Why not take this opportunity to make the switch to paperless transactions?
Electronic claim submission can help streamline your administrative processes, help protect your patients’ information and may result in faster claims processing and payment. Learn more... 

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