New CMS-1500 Forms Required Soon

CMS has announced deadline dates for use of the new CMS-1500 form that will be ICD-10 compatible. CMS will begin accepting the new paper form (for those who have a special exemption to send paper Medicare claims) on January 6, 2014. Starting April 1, 2014, Medicare will accept only the new form. The information and links below are from an email notification we received on September 5, 2013.

CMS-1500 Claim Form Updates: Medicare to Accept Revised Form Starting January 2014

The CMS-1500 Claim Form has been recently revised with changes including those to more adequately support the use of the ICD-10 diagnosis code set. The revised CMS-1500 form (version 02/12) will replace version 08/05. The revised form will give providers the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes, which is important as the October 1, 2014, transition approaches. ICD-9 codes must be used for services provided before October 1, 2014, while ICD-10 codes should be used for services provided on or after October 1, 2014. The revised form also allows for additional diagnosis codes, expanding from 4 possible codes to 12. 

Only providers who qualify for exemptions from electronic submission may submit the CMS-1500 Claim Form to Medicare. For those providers who use service vendors, CMS encourages them to check with their service vendors to determine when they will switch to the new form.

Medicare will begin accepting the revised form on January 6, 2014. Starting April 1, 2014, Medicare will accept only the revised version of the form.

As you know, other insurers will follow CMS’ lead on use of the new form; you will need to find out from them when they will require the new form. SOS, like most other software vendors, will provide the new format for customers with current support agreements. But you will need to purchase the forms and use them…unless you have wisely moved to electronic claim filing!


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