The changes are relatively minor but a couple missteps could result in your claims no longer being paid.
To help us along, Ginkgo Software put together a great video outlining all the changes. You can view it HERE, its quite comprehensive.
In addition, here is a shorter list of the most noticeable changes that could result in you not getting paid if you don't select the right options:
Box 14 requires a qualifier for any date listed there (only used in auto accidents, worker’s comp, and pregnancy). Use 431 for “Onset of Current Symptoms (i.e. accident) or 484 for Date of Last Menstrual Period
Box 15 also requires a qualifier for the date. Use the following as/if applicable:
- 454 Initial Treatment
- 304 Latest Visit or Consultation
- 453 Acute Manifestation of a Chronic Condition 439 Accident
- 455 Last X-ray
- 471 Prescription
- 090 Report Start (Assumed Care Date)
- 091 Report End (Relinquished Care Date)
- 444 First Visit or Consultation
Box 21 is now numbered instead of lettered. Be sure to translate the LETTERS corresponding to your diagnosis codes to Box 24e the Diagnosis Pointer instead of numbers as before. THIS IS THE MOST CRITICAL CHANGE TO SUCCESSFULLY FILING OUT AND FILING THE 02-12 VERSION FORM. Box 21 also includes an “ICD Indicator” Enter a 9 here if you are using ICD-9 codes or a 10 here if you are using ICD-10 codes.
Box 24c Instead of a number indicator, now enter simply “Y” for Yes, this treatment is related to an emergency or “N” for No, this treatment is not related to an emergency.
Box 24e Enter letters corresponding to the diagnosis code lines in Box 21 instead of numbers as before. I.e. if you have one diagnosis, enter “A” on each procedure code line in this box, two diagnoses, enter “AB” and so on.
You can also link to a complete guide from the NUCC by clicking HERE.
Good luck everyone, and stay on your toes! If you have trouble with the new form feel free to ask questions in the comments section below and I'll do my best to answer them.
Here's to your Insurance Billing Success,