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Note: the information below is for the 0805 cms1500 form. Be sure to
check out the information for the new 0212 form.
CMS 1500 Claim Form (HICF 1500)
Here are some names associated with this new claim form
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NUCC - National Uniform Claim Committee
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NUBC - National Uniform Billing Committee
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HICF - Health Insurance Claim Form
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NPI - National Provider Identifier
NUCC recommends that health plans, clearinghouses, and other
vendors be ready to handle the revised CMS-1500 by October 1, 2006, and
that physicians plan on using the form exclusively by Feb. 1, 2007.
Following this timeline will ensure the revised form is up and
running well before the May 23, 2007, deadline to use the NPI for
all claims submissions.
At first glance the form looks similar to the old CMS 1500 form.
The primary change will be a place for the NPI.
There are many other changes. For example some interesting
changes such as a place for 4 characters to the right of the decimal
in the diagnosis code.
Here is the best web site we have found with information about
the form:
http://www.nucc.org/content/view/13/1/
The NUCC recommended timeline for transitioning to the new
version of the 1500 Claim Form is as follows:
a. October 1, 2006
Health plans, clearinghouses, and other information support vendors
should be ready to handle and accept the revised (08/05) 1500 Claim
Form.
b. October 1, 2006 - February 1, 2007
Providers can use either the current (12/90) version or the revised
(08/05) version of the 1500 Claim Form.
c. February 1, 2007
The current (12/90) version of the 1500 Claim Form is discontinued;
only the revised (08/05) form is to be used. All rebilling of claims
should use the revised (08/05) form from this date forward, even
though earlier submissions may have been on the current
(12/90) 1500 Claim Form.
Because the current 1500 Claim Form (version 12/90) is due to
expire with the OMB in March 2006, it will be renewed to allow its
continued use during this transition period.
In addition to revising the 1500 Claim Form, the NUCC has drafted a
reference instruction manual detailing how to complete the form. The
purpose of this manual is to help standardize nationally the manner
in which the form is being completed. The instruction manual is
posted above.
The NUCC began the revision of the current (12/90) 1500 Claim Form
in June 2004. It was recognized that a revision of the form was
needed in order to accommodate the reporting of the new NPI number.
The NUCC's Data/1500 Subcommittee worked on how to best revise
the current form to accommodate the reporting of the NPI while
limiting the changes to only those that were necessary so that the
re-programming needed to be done by the industry could be kept to a
minimum. During the revision of the form, two public comment
periods were held, one in December 2004 to February 2005 and the
other in June to July 2005, to solicit feedback on the proposed
changes. The revised version was voted on and approved by the NUCC
at the August 2005 meeting. For a list of the changes from the
current (12/90) version to the revised (08/05) version, view the
change log document posted above.
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