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New 1500 Claim Form: Timeline Update

on 17 December, 2013

As mentioned in a previous article, the NUCC (National Uniform Claim Committee) has recently released the newest version of the CMS-1500 form – revision 02/12. This new revision includes several changes, including the addition of eight extra diagnosis codes to help prepare for the upcoming ICD-10 implementation. A QR code and an ICD-9 or ICD-10 indicator have also been added to the form. 

Payers will begin to receive and process version 02/12 on January 6, 2014. There will be a dual period from January 6 through March 31 in which both the old version, 08/05, and the new version will be accepted. After April 1, only version 02/12 will be able to be processed.

This dual period allows for payers to gradually adjust to processing the new changes on the 02/12 form. It is essential for claims processing software to be able to process both versions of the form during these few months.