The Centers for Medicare & Medicaid Services (CMS) has provided its Medicare contractors with information for the implementation of the revised 1500 Claim Form. As of January 6th, 2014 Payers began using the new 1500 claim form (version 02/12). Medicare will accept the old 1500 claim form but not for long.  On April 1 only the new form will be accepted. The updated form accommodates ICD-10 reporting and is one more step in your practices ICD-10 Readiness.

The Administrative Simplification Compliance Act (ASCA) requires Medicare claims to be sent electronically unless certain exceptions are met. Those providers meeting these exceptions are permitted to submit their claims to Medicare on paper.

New CMS 1500 claim form will help ICD-10 Readiness with changes that include:

  • Item Number 21 has an indicator to identify the diagnosis code version (ICD-9 or ICD-10)
  • Expansion from 4 to 12 of the number of diagnosis codes that can be reported (Item Number 21)
  • Item Number 17 includes the ability to identify the role of the provider
  • Item Number 14 includes the specific dates reported

As of January 6th, 2014 payers began receiving and processing the paper claims provided on the revised CMS 1500. Both the old and new version will be accepted until April 1st, at which time only the revised form will be accepted. This means that Medicare will reject claims submitted on the old claim form after April 1, and that means you won’t get paid.

For complete instructions download the CMS guide for the new CMS 1500 Claim Form instructions. You can also visit to request an ICD-10 Readiness assessment.

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