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)

Artificial Intelligence in Healthcare - A Medical Coder's Perspective
December 26th, 2023 - Aimee Wilcox
We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities? 
Specialization: Your Advantage as a Medical Coding Contractor
December 22nd, 2023 - Find-A-Code
Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.
ICD-10-CM Coding of Chronic Obstructive Pulmonary Disease (COPD)
December 19th, 2023 - Aimee Wilcox
Chronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.
Changes to COVID-19 Vaccines Strike Again
December 12th, 2023 - Aimee Wilcox
According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.
Updated ICD-10-CM Codes for Appendicitis
November 14th, 2023 - Aimee Wilcox
With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.
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),....

Home About Terms Privacy

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

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association