Revised Health Insurance Claim Form CMS-1500
The current version of Form CMS-1500 (12-90) is being revised to accommodate the reporting of the National Provider Identifier (NPI). The revised version will be Form CMS-1500 (08-05). Chapter 26 is being revised to accommodate the updates for the new version. The following changes/updates are being made to Chapter 26: 1) An explanation of the revised version of the form is being added to Section 10, 2) Appropriate NPI language has been added to Fields 17 and 17a, 3) New field 17b is introduced and defined, 4) Information on surrogate UPINs has been removed and will be covered in a new IOM Chapter, 5) Introduction of the new shaded area of Field 24, 6) Introduction of the new Field 24j, 7) Appropriate NPI language has been added to Fields 32 and 33 and introduction of new fields 32a, 32b, 33a, and 33b, 8) Section 20 has been re-titled, 9) New section 30 has been added, and 10) Two Exhibits (1500 User Print file Specifications) have been added.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 31, 2006
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