ICD-10 updates: Providers must use new 1500 form by April 1

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Author Name:  Jennifer Bresnick

Article Date:   March 24, 2014

Source:            EHR Intelligence

Site:                 http://ehrintelligence.com/2014/03/24/icd-10-updates-providers-must-use-new-1500-form-by-april-1/

 

Title:               ICD-10 updates: Providers must use new 1500 form by April 1 

 

For those providers who are still submitting their Medicare claims on paper, there’s one ICD-10 change that is coming a lot sooner than October 1, 2014.  Paper-based providers are reminded that only the updated CMS 1500 form will be accepted for all claims received on or after April 1, 2014.  The new forms were released in the summer of 2013 and provide ICD-10-friendly changes to help prepare billers and coders for the new standards.

While the new Version 02/12 forms have been acceptable since January, providers and suppliers who meet exceptions to the electronic reporting requirement under the Administrative Simplification Compliance Act (ASCA) will no longer have a choice about which paperwork to use.   The Version 02/12 form replaces the old Version 08/05 form, which did not contain any provisions for the updated code set. 

“The revised form has a number of changes,” explains a CMS MLN Matter bulletin on the subject. “Those most notable for Medicare are new indicators to differentiate between ICD-9 and ICD-10 codes on a claim, and qualifiers to identify whether certain providers are being identified as having performed an ordering, referring, or supervising role in the furnishing of the service. In addition, the revised form uses letters, instead of numbers, as diagnosis code pointers, and expands the number of possible diagnosis codes on a claim to 12.”

The National Uniform Claim Committee (NUCC), which provides periodic updates of necessary claims paperwork, has developed detailed instructions for the use of the new form, including sample documentation and the specific information required for each field in order to help coders and billers understand the changes so claims can be processed quickly.

Providers are reminded, however, that ICD-10 codes on their own will not be accepted for claims dated before October 1, 2014, even though there is room for them on the form.  Providers who use the new 1500 form must use ICD-9 codes for services performed before the implementation date, and must use only ICD-10 codes for services occurring after the mandated deadline.

 

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