New 1500 Health Insurance Claim Form Released [Updated]

New 1500 Health Insurance Claim Form Released [Updated]

The National Uniform Claim Committee (NUCC) announced on February 15, 2013, the implementation of the newest version of the health insurance claim form, which is to be denoted as 02/12.

There are several changes to the form, however, the major change noted is in the diagnosis box 21. Up to 12 diagnosis codes may be used. The decimal point has been eliminated, thus allowing for ICD 10 codes to be used on this claim form.

Doctors and suppliers are encouraged to begin working with their billing companies and clearinghouses to accept the newest form. Centers for Medicare and Medicaid Services (CMS) has approved the following timeline:

  • January 6, 2014 – CMS will be ready to handle and accept the revised 1500 claim form version (02/12). [updated]
  • January 6 – April 1, 2014 – providers can use either the current (08/05) version of the health claim form or the revised version (02/12) 1500 claim form. CMS will process either form. [updated]
  • April 1, 2014 – the current version (08/05) 1500 health claim form is discontinued; only the revised (02/12) 1500 claim form is to be used. All further billing of claims will be on the revised (02/12) 1500 claim form this date forward, even though earlier submissions may have been on the current (08/05) 1500 claim form. [updated]

The original transition timeline submitted by and NUCC was dependent on other variables such as the approval by the Centers for Medicare and Medicaid Services (CMS). However, CMS has officially announced the dates above. [updated]

About Author

Mario Fucinari DC, CCSP, APMP, MCS-P, CPCO

Dr. Mario Fucinari has helped train doctors and staff over the last 20 years. He received his bachelor's degree from Wayne State University in Detroit and his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1986. Dr. Fucinari was the recipient of the 1998 and the 2003 President's Award from the Illinois Chiropractic Society (ICS) for his work with education and training and most recently received the 2012 Chiropractor of the Year award from the ICS.

Dr. Fucinari was the first chiropractic physician to attain the Certified Medical Compliance degree. Two years later he earned his degree as a Certified Instructor for the Certified Medical Compliance Program. He is now the Chairman of the Chiropractic division of the national medical compliance program. He has produced classes and publications on HIPAA, Clinical Documentation, Medicare, and Stroke and Cervical Manipulation. He is a worldwide speaker for NCMIC, Foot Levelers, ChiroHealthUSA and several state associations and a Certified Chiropractic Sports Physician [CCSP].


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