Form Version 02/12 will replace the
current CMS 1500 claim form, 08/05, effective with claims received on and after
April 1, 2014:
Medicare will being accepting claims
on the revised form, 02/12, on January 6, 2014;
Medicare will continue to accept
claims on the old form, 08/05, through March 31, 2014;
On April 1, 2014, Medicare will
accept paper claims on only the revised CMS 1500 claim form, 02/12; and
On and after April 1, 2014, Medicare
will no longer accept claims on the old CMS 1500 claim form, 08/05.
The National Uniform Claim Committee
(NUCC) recently revised the CMS 1500 claim form. On June 10, 2013, the White
House Office of Management and Budget (OMB) approved the revised form, 02/12.
The revised form has a number of changes. 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 qualifiers that are appropriate
for identifying an ordering, referring, or supervising role are as follows:
DN – Referring Provider
DK – Ordering Provider
DQ – Supervising Provider
Providers should enter the qualifier
to the left of the dotted vertical line on item 17.
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. Medicare requires that
Medicare therefore for professional and supplier paper claims be the CMS 1500
claim form. Medicare therefore ssuppoers the implementation of the CMS 1500
claim form and its revisions for use by its professional providers and
suppliers meeting an ASCA exception.

News Flash
: Generally, Medicare Part B covers one fly vaccination and its administration
per flu season for beneficiaries without co-pay or deductible. Now is the
perfect time to vaccinate beneficiaries. Health care providers are encouraged
to get a flu vaccine to help protect themselves from the flu and to keep from
spreading it to their family, co-workers and patients.
Note: The flu vaccine is
not a Part-D covered drug.