CMS-1500 form revised to fit more diagnosis codes, less patient demographic information

February 28th, 2014 - Scott Kraft
Categories:   Claims   Diagnosis Coding  

CMS-1500 form revised to fit more diagnosis codes, less patient demographic information
It doesn’t get used nearly as much as it used to, but there is a new CMS-1500 claim form that has been revised slightly to fit more diagnosis codes and to facilitate the transition to the ICD-10-CM coding system set for Oct. 1, 2014. The new CMS-1500 form will also collect a little less patient information.

While most claims are now filed electronically, changes to the paper CMS-1500 often result in changes to the information collected in an electronic claims filing.

Here’s what you need to know, according to CMS transmittal 2842 to the Medicare Claims Processing Manual:
  • The new CMS-1500 form is recognized by the date of (02/12) in the lower right corner, replacing the (08/05) used on the current form.
  • CMS will permit the use of either CMS-1500 form for the first quarter of 2014, but claims received on or after April 1, 2014, must be on the new (02/12) form.
  • The new CMS-1500 will hold as many as 12 diagnosis codes. The current form holds only four, though electronic claims must accept at least eight.
  • There is a new space for an indicator in the diagnosis code area. CMS instructs you to use the indicator 0 when reporting ICD-9 codes and 9 when reporting ICD-10 codes.
  • There is space for three new modifier-type codes to use in Box 17. Use DN to indicate a referring provider, DK for an ordering provider and DQ for a supervising provider. When filing a paper claim form, you would need an additional claim form when there are multiple ordering, referring or supervising providers. An electronic claim can likely handle this information.
  • You no longer would report the patient’s marital, employment or student status in Box 8.


Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.

Latest articles:  (any category)

COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....
Can We Score Interpretation of an EKG Towards E/M Medical Decision Making?
October 10th, 2023 - Aimee Wilcox
When EKGs are performed in the facility setting or even in the physician's office, what are the requirements for reporting the service and who gets credit for scoring data points for Evaluation and Management (E/M) medical decision making (MDM)? Let's take a look at a few coding scenarios related to EKG services to get a better understanding of why this can be problematic.
Accurately Reporting Signs and Symptoms with ICD-10-CM Codes
October 5th, 2023 - Aimee Wilcox
Coders often find themselves unsure of when to report a sign or symptom code documented in the medical record. Some coders find their organization has an EHR that requires a working diagnosis, which is usually a sign or symptom, be entered to order a test or diagnostic study or image. Understanding the guidelines surrounding when signs and symptoms should be reported is the first step in correct coding so let's take a look at some scenarios.
The 2024 ICD-10-CM Updates Include New Codes for Reporting Metabolic Disorders and Insulin Resistance
September 19th, 2023 - Aimee Wilcox
Diabetes is a chronic disease that just seems to consistently be increasing instead of improving resulting in a constant endeavor by medical researchers to identify causal effects and possible treatments. One underlying or precipitating condition that scientists have identified as a precipitating factor in the development of diabetes is insulin resistance, which is a known metabolic disorder. As data becomes available through claims reporting, additional code options become possible with ICD-10-CM.
Documenting and Reporting Postoperative Visits
September 12th, 2023 - Aimee Wilcox
Sometimes we receive questions regarding documentation requirements for specific codes or coding requirements and we respond with information and resources to support our answers. The following question was recently submitted: Are providers required to report postoperative services on claims using 99024, especially if there is no payment for that service? What documentation is required if you are reporting an unrelated Evaluation and Management (E/M) service by the same physician during the postoperative period? 
Understanding Gastroesophageal Reflux Disease and ICD-10-CM Coding
August 22nd, 2023 - Aimee Wilcox
Gastroesophageal reflux disease or GERD for short, is a disease that impacts millions of Americans on a weekly basis. Symptoms are uncomfortable, as are some of the tests used to diagnose it, but understanding the disease, tests, and treatments helps us better understand how to code the disease using ICD-10-CM codes.

Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2023 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association