Physicians and other providers and suppliers who submit Medicare paper claims are now required to use the updated CMS-1500 claim form (Version 01/12). The grace period to transition to the new form expired today. Commencing April 1, 2014, Medicare no longer accepts claims on the prior CMS-1500 claim form (Version 08/05). Various other payors also require use of the new CMS-1500 form.
The Administrative Simplification Compliance Act (ASCA) requires the electronic submission of claims unless an exception is satisfied, in which case claims may also be submitted on paper using the CMS-1500 claim form. The exceptions allow small providers (fewer than 25 full-time equivalent (FTE) employees) and small suppliers (fewer than 10 FTEs), and in some circumstances other providers and suppliers, to submit paper claims. The revised CMS-1500 form incorporates a number of changes to the prior version, including new indicators to distinguish between ICD-9 and ICD-10 codes and qualifiers to identify professionals ordering, referring or supervising the services. Other changes include the use of letters (rather than numbers) as diagnosis code pointers and the expansion of the number of possible diagnosis codes.
For more information, see Medicare Learning Network ( MLN) Matters 8509 (http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8509.pdf ) and CMS-1500 claim form (http://www.nucc.org/%5Cimages%5Cstories%5CPDF%5C1500_claim_form_2012_02.pdf ).