Revised CMS 1500 Form Changes- At a Glance

Revised CMS form thumbnail - AZCOMP TechnologiesWhat changed on the CMS form?

Many people have wondered what changes are on the new CMS 1500 form. (Unless you’ve been hiding under a rock for the last few months, you’ve heard that CMS 1500 form version 02/12 is replacing version 08/05) starting April 1, 2014.

So, her’s a list of the changes for your quick review. Or you can download our one page guide showing you the changes. These changes may not be really exciting, but it’s good to scan and be aware of the changes taking effect.

Revisions to the new CMS 1500 02/12 form include:

  1. The 1500 symbol in the upper left corner is replaced with scannable QR code
  2. Changes were made payer ID number requirements under section 1
  3. “Patient Status” was removed from section 8
  4. “Employer’s Name” and “School Name” were removed from section 9
  5. Section 10d was changed to read, “Claim Codes (Designated by NUCC)”
  6. Section 11b was changed to read, “Other Claims ID (Designated by NUCC)”
  7. The field layout was modified slightly in Section 14
  8. Under section 15 the statement “If Patient Had Same or Similar Illness” was removed
  9. The words, “Name of Referring Provider or Other Source” were added to help identify the provider being reported under section 17
  10. In Box 19 additional claim information designated by NUCC must be completed according to NUCC guidelines.
  11. In Section 21, eight lines were added for diagnosis codes and were changed from numeric labels to alpha labels.
  12. Also, In Section 21 you must indicate if using ICD-9 or ICD-10 codes
  13. The diagnosis pointers in Box 24e are now alpha characters instead of numeric
  14. “Balance Due” was removed from section 30

Download our free PDF of the CMS 1500 form revisions.

Medisoft v19 and Lytec 2014 are the only versions capable of handling the new CMS form. If you send any paper claims- including rebills you will need to upgrade to the new version before April 1st.

New CMS 1500 Form 02-12 - AZCOMP Technologies

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AZCOMP Technologies
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