CMS 1500 Claim Form Revised to Accommodate ICD-10 Codes

Rollout Expected in 2014

August 02, 2013 11:36 am News Staff

Note to family physicians: Refrain from purchasing large quantities of CMS' current 1500 claim form that is used to submit paper claims to Medicare. That form has been updated to accommodate and implement the ICD-10-CM diagnosis code set, among other things.

[This just posted]

The new 1500 form -- officially designated as "version 02/12" -- was approved by CMS and the Office of Management and Budget earlier this summer.

Physicians who submit their claims electronically should be in touch with their software vendors about timelines for updating practice management systems to accommodate the new form.

Physicians will notice two significant changes on the new form. Version 02/12 will give physicians the ability to

  • identify whether they are using ICD-9 or ICD-10 codes (a particularly important feature during the transition period scheduled to occur in 2014) and
  • use as many as 12 codes in the diagnosis field (the current limit is four).

Although a start date for using the form has not been announced, CMS has created a tentative timeline for its implementation(

  • Jan. 6, 2014 (tentative) -- Medicare begins receiving and processing paper claims submitted on the revised CMS 1500 claim form.
  • Jan. 6-March 31, 2014 (tentative) -- dual use period when Medicare receives and processes paper claims submitted on the old CMS 1500 claim form and the new claim form.
  • April 1, 2014 (tentative) -- Medicare receives and processes paper claims submitted only on the revised CMS 1500 claim form.