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PPG New Claim Form Required Starting April 1
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New Claim Form Required Starting April 1

 
 
 
An important reminder: the new, updated version of the CMS-1500 claim form (aka the 2/12 version of the CMS-1500) will be required by Medicare for paper claims received on or after April 1, 2014. Private insurance companies often follow Medicare's lead and are likely to require the changeover at the same time; you can confirm this with individual insurance companies.
 
It's wise to begin using the new 2/12 version of the CMS-1500 now, since claims submitted now may be received on or after April 1. The 2/12 version of CMS-1500 should be used regardless of the dates of service reported.
 
The 2/12 version of CMS-1500 is designed to accommodate the recent change in diagnostic coding from the old DSM to the new ICD-9-CM codes. You will still need to use the DSM-5 for up-to-date descriptions of the diagnoses, while the codes for reporting the diagnoses will be ICD codes. The DSM-5 and ICD work together; one does not replace the other. The ICD codes are found in the new DSM-5 manual.
 
The new 2/12 CMS-1500 form also eliminates some of the old fields. Instructions for completing the new 2/12 version of the CMS-1500 can be found by following the links at www.naswnyc.org/ppgresources : under the heading "Insurance & Managed Care Issues" click on "CMS-1500 Claim Form" and then click on the link under the heading "Instructions for Completing the Revised Form."

There are many places to purchase the 2/12 CMS-1500 forms. You can purchase them directly from the US Government Printing Office or from one of many private resellers including the large office supply chain stores.

A related issue: if you are not already doing so, I urge you to consider using software to print, rather than handwrite, your paper claims; printed claims are more easily processed by Medicare's computerized system, and therefore seem to involve fewer processing snafus. One such easy to use software program can be purchased for just $55.

 

 

 

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