1500 CMS Form

Last Updated on Saturday, 03 October 2009 19:23

Introduction to CMS-1500 Form.

The CMS-1500 Form modified to incorporate the new National Provider Identifier (NPI) numbers is the most frequently used reimbursement form by medical providers who perform health and mental health services in outpatient settings. It is very important that the CMS 1500 forms are completed properly to ensure that correct payment is made.

The only acceptable claim forms are those printed in Flint OCR Red, J6983, (or exact match) ink. The majority of paper claims sent to carriers  are scanned using Optical Character Recognition (OCR) technology. Printers have different characteristics under different OS and drivers and it may be necessary to calibrate the selected printer to align the information properly when printing data onto pre-printed CMS 1500 forms. It may not be possible to get the data to print precisely in each box or field and it is not required to do so. Data need only be printed in the approximate assigned area to be successfully read by scanners.

Resources

1. Please check the National Uniform Claims Committee (NUCC) instruction manual, available online.

2. A PDF version of the revised form is available for testing online. The file contains three different versions of the same 1500 form: one in a standard format, one in a grid format and one in a template format. The PDF file might not print to exact specifications. Print specifications are available in Appendix A of the NUCC instruction manual referenced earlier.

3. NPI FAQs from the American Academy of Family Physicians.

1500 CMS software and Medical Office One

On the CMS 1500 screen of the software the  Insert Patient Data button allows you to enter default information that will automatically flow through the EMR Portion(like name, address, zip codes,etc)  as well as Provider and Facility Details  and codes (ICD-9CM, CPT). Though you may have parts of your invoice auto-entered, you can still change those fields on each invoice if you wish.

Click on Update Transactions button in order to update existing patient transactions from database.
After that you can simply type data on remaining fields or alter existing fields. To enter information, click on the appropriate field or use the Tab key to move through the fields. Each field will displayed in light green color as an indicator that the field can be edited. All check boxes require an V as input. The left mouse button will place an V in the box that will always be converted to an X on printed forms.

When entering information onto 1500 form you should refrain from using punctuation such as periods, commas, hyphens, slash-backslash  because the form may be rejected due to scanning errors. However you must use a comma to separate the Last Name from the First Name and Middle Name in Box 2 of the form. You may also use a hyphen ( - ) when entering zip codes as 9 digit codes or backslash ( / ) when entering dates in Box 12 and Box 31.

On any of the black arrows buttons Click to select existing data like Transactions, NPI Number, Other ID Number into a given field of the appropriate 1500 data box. These data can also be typed in if they are not already in the database.

For each case, choose up to four ICD-9-CM diagnoses. These diagnoses will appear on superbills as well as on the  1500CMS form’s box 21. By default, Medical Office One retrieve diagnoses from Patient Codification screen, but you may choose to find a code directly as well from Search button.

When you are finished entering information the closing or printing  will be automatically save form data. Printing on a pre-typed CMS will be lock the form fields and each field will displayed in white color as an indicator that the field cannot be edited any more. However you will be able to unlock data fields with Unlock Data button

On any of the black arrows Click to select information's from the central database like transactions or providers.

If a given Medical Term is associated with a CPT Code in Medical Terminology screen, fields like MM DD YY and $ Charges will be also automatically updated.

Medical Office One comes with a full set of up to date ICD-9-CM codes and CPT Codes. Biosoftworld is not responsible in any way for the accuracy of the codes or whether or not a given insurance company will reimburse for them. It is your responsibility to keep up with the ICD-9 (diagnosis) and CPT (procedure) codes as they change from year to year, and use those which are appropriate to your practice.

The following button will be delete Box 24 data.

The following boxes require you enter the provider's NPI number and/or their Other I.D. number:
Box 17 A
Box 24 I (qualifier) lines 1 thru 6
Box 24 J (number) lines 1 thru 6
Box 32 A & B
Box 33 A & B

Proceed to printing

If the printed data does not properly align with the fields and boxes of the pre-printed 1500 form see Printer Calibration on Help File.

Share this page