If you use the CMS 1500 claim form—whether the paper form or a data-entry version in your practice management system—now’s the time to make sure you have the latest version, announced in the summer. Beginning April 1, payers no longer will accept the older version of the form for payment.
This updated claim form, known as “version 02/12,” includes revisions that should improve the accuracy of the data included, accommodating reporting needs tied to current standards for electronic health care transaction and the new ICD-10 code set.
Two changes of special note include the ability to identify whether the claim is using ICD-9 or ICD-10 as the diagnosis code set, and the diagnosis field will allow up to 12 codes instead of the current limit of four.
Experts say there are five steps your practice should take now to prepare for the switch:
- If you use a paper form, obtain the revised form from your supplier.
- If you use a digital version, contact your practice management system vendor to coordinate your software upgrade.
- Determine when the payers and other trading partners, such as clearinghouses, will begin accepting the revised form.
- Conduct testing with your trading partners.
- Monitor how your claims are being processed using the new form so you can identify any possible issues.
Resources are available online from the National Uniform Claim Committee, which is charged with maintaining the CMS 1500 claim form.
