April 1 deadline to begin using new CMS 1500 claim form

New form accommodates ICD-10 codes that practitioners will begin using on Oct 1, 2014.

Practitioners who bill Medicare must begin using the new CMS-1500 claim form by April 1, 2014. Providers can use either version of the form until March 31, but payers will no longer accept the old form, version 08/05, as of April 1. 

The revised CMS-1500 claim form, version 02/12, was designed to accommodate ICD-10 reporting needs and to align with electronic reporting standards. Though the 02/12 form is ICD-10 ready, The Centers for Medicare and Medicaid Services (CMS) indicates that providers should not begin using ICD-10 codes until Oct. 1, 2014 (PDF, 552KB). Services provided before Oct 1, 2014, must use ICD-9 diagnosis and inpatient procedure codes.

Notable changes to the form include: new indicators to differentiate between ICD-9 and ICD-10 codes and the use of letters instead of numbers on the lines where diagnosis codes are listed. In addition, the revised form expands the number of possible diagnosis codes that can be listed on a claim to 12.

The National Uniform Claim Committee, which maintains the CMS-1500 claim form, offers some tips for providers preparing to switch to the new form:  

  1. Check with your current vendor about ordering the new 02/12 forms (either paper or electronic if applicable).
  2. If switching before April 1, you may want to contact payers to confirm they are accepting the new form.
  3. Review any payer-specific instructions you receive.

Additional resources, including a sample 02/12 claim form and instructions, are available from NUCC and the Centers for Medicare and Medicaid Services (CMS).