The new CMS 1500 form version 02/12 is required for use starting April 1st - are you ready?

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,
~Rebecca

If you're looking for a good comprehensive ICD-10 code list, I've got a great resource for you - HIPPASpace.  Its a resource I'd used before to get NPI numbers for referring physicians, but hadn't used in a while until this week.  When I went to the site they had this magical incredible FREE ICD-10 lookup and its just too cool not to share.

You can enter a diagnosis like "fibromyalgia" or a simple category such as "pain" and get a full list of current ICD-10 codes.  Once you get the list you can choose a "mapping" option which will compare the chosen ICD-10 codes to current ICD-9 codes as well to help you understand if you've translated the code appropriately.

ICD-10 codes are much more complicated than ICD-9.  In physical medicine, for instance, the 7 digit codes include not only coding for the affected body part and type of pain/injury but also whether it is an initial treatment or follow up treatment for the injury so it is important to understand the coding language and sequence enough to choose correctly.

Still, for a quick way to just get the numbers and start translating what you have in ICD-9 to an initial subset of ICD-10 codes, this is a great free resource.

AAC's AcuCode 2014 - a comprehensive list of ICD codes for acupuncturists specifically - is now ready and available for purchase after being out for several months.  This year, they've taken their coding manual digital, so the annual fee includes instant access to their online database as well as a physical copy of the book which will print and ship beginning in October.

If you want a pared down set of codes specific to your profession, this is a good resource and still a comprehensive list.

The new CMS 1500 form, version 02/12, is now available and will be in use starting January 2014.  Mandatory use of version 02/12, however, has bee pushed back from October this year to April 2014 so we all have a little more time to review and implement this new claim form.

Its only taken me 3 years, but voila!  Website update which was a long time coming!  Poke around and check it out - new look, new blog, new affiliate site, pretty sweet!

That's right, it is on its way slowly but surely so hold on tight and keep up the prep work.  Currently, ICD-10 isn't required until October 1, 2014 so we still have a long time to complete our coding changes, test our systems and prepare.  But the key is PREPARATION - don't wait until the last minute!  Start compiling your code sets now so that when October 1st 2014 rolls around you are well tested and ready.

I promise I will have a book update out by then too, so stay tuned!  I will include the basic codes necessary for Acupuncturists as I did in my first edition.  You can also peruse codes at the official CMS ICD-10 website but it is rather unwieldy to search through them all.

A great code set that's been parsed down for Acupuncturists is available from the American Acupuncture Council for about $50, but it is currently sold out!  I will endeavor to post when they are available again, or you can contact AAC direct and ask if they can notify you.

Okay, guys, this one is a biggie - beginning October 1st 2013 a NEW HCFA/CMS 1500 form called version 0212 will be required for insurance billing.  You can see a PDF version HERE and you can read more on the NUCC website HERE.  Undoubtedly, your clearinghouses are already testing this new form and will be prepared to process it.  I haven't heard or seen anything about availability at stores like Office Depot or the like for purchasing pre-printed blocks of these, as you can with the current CMS 1500, but we can only assume that is coming too since its kind of a necessity for compliance.

The only CAM friendly database system that I know is assured to have the new CMS 1500 0212 built into the system is ClientTracker by Ginkgo Software.  So if you're thinking of investing in a new system for your practice, I highly recommend this one - it is what I use and I wouldn't be without it.  They have a multi-user cloud system on its way that can be accessed using both your computer and your tablet devices which is pretty sweet.

Them's the haps, people.  Stay tuned for more insurance billing, practice building and Insurance Billing Made Easy updates - I promise there will be more to come!

Oh, and have you signed up for my ezine?  If not, you should! Free tips delivered to your inbox and not spammy, I promise!