Industry News

CMS Issues Transmittal Revising Instructions for Form CMS-1500.

Jennifer Kirchner | December 2013

The Centers for Medicare & Medicaid Services (CMS) issued a transmittal revising instructions for Form CMS-1500 to reflect the updated form, version 02/12. The form was recently revised by the National Uniform Claim Committee (NUCC). Version 02/12 replaces the current Form CMS-1500, version 08/05. Medicare will begin to accept claims on the new form, version 02/12, starting January 6, 2014. However, Medicare will continue to accept claims on the old form, version 08/05, through March 31, 2014.

The most notable changes on the revised form include:

  • New indicators to differentiate between ICD-9 and ICD-10 codes on a claim;
  • Qualifiers to identify whether certain providers are being identified as having performed an ordering, referring, or supervising role in the furnishing of the service;
  • Letters, instead of numbers, used as diagnosis code pointers;
  • The number of possible diagnosis codes on a claim is extended to 12.
  • Providers are instructed not to submit claims with ICD-10 claims prior to the ICD-10 implementation date of October 1, 2014.

The CMS transmittal (2842) revising the Form CMS-1500 instructions is available at:

Centers for Medicare & Medicaid Services. “Form CMS-1500 Instructions: Revised for Form Version 02/12.” Transmittal 2842. 27 Dec. 2013.

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.