1500 Claim Form Tips

August 3rd, 2016 - ChiroCode
Categories:   Medicare   Billing  
0 Votes - Sign in to vote or comment.

The following rules for the 1500 claim form are excerpts from NUCC and Medicare instructions, but they are generally universal and apply to claims submitted either electronically or on paper. Please note that payment rules can change frequently for any payer, so consult with specific insurance payers for their adaptations.

The following excerpts listed in the 2016 ChiroCode Deskbook give you instructions from the following documents along with commentary by ChiroCode:

• 1500 Health Insurance Claim Form Reference Instruction Manual for Form Version 02/12 (version 3.0 07/15), by the National Uniform Claim Committee (NUCC).

• Medicare instructions by CMS (Rev. 3255, 05-08-15).

Please note that this segment only contains instructions or information that should be paid close attention to when submitting claims. Complete instructions are available online.

Resource: See Resource 178 for the complete list of line items and their associated guidelines and revisions, including exclusive ChiroCode tips. This resource is free for ChiroCode members.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

Preview the PDGM Calculator for Home Health Today
December 4th, 2019 - Wyn Staheli, Director of Research
Until February 1, 2020, you can preview Find-A-Code's Patient-Driven Groupings Model (PDGM) home health payment calculator by going to https://www.findacode.com/tools/home-health/ .
Hypertension ICD-10-CM Code Reporting Table
November 25th, 2019 - Wyn Staheli, Director of Research
In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options.
New Medicare Home Health Care Payment Grouper — Are You Ready?
November 25th, 2019 - Wyn Staheli, Director of Research
In 2020, Medicare will begin using a new Patient-Driven Groupings Model (PDGM) for calculating Medicare payment for home health care services. This is probably the biggest change to affect home health care since 2000.
VA: How UCR Charges are Determined
November 20th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
How does the VA determine charges billed to third party payers for Veterans with private health insurance? According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...
Medical Insurance Coverage for TMJ Disorders (TMD)
November 19th, 2019 - Christine Taxin
It is agreed that TMJ disorders should be covered by insurance. There are often questions whether it is covered by medical insurance or dental insurance and where the line is that separates coverage.Medical Insurance typically is the primary insurance for TMJ disorders. The reason is that joints are found anywhere ...
Changes to Portable X-Ray Requirements
November 19th, 2019 - Wyn Staheli, Director of Research
On September 30, 2019, CMS published a final rule which made changes to portable x-ray services requirements as found in the law.
Q/A: Q/A: How do I Code a Procedure for the Primary Insurance so the Secondary Can Get Billed?
November 19th, 2019 - Wyn Staheli, Director of Research
Question: How do you modify a code submitted to the primary insurance company to let them know it is not covered by them so you can bill to a secondary?



About Codapedia by innoviHealth Contact Us Terms of Use Privacy Policy Advertise with Us

innoviHealth - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2000-2019 innoviHealth Systems, Inc. - CPT® copyright 2018 American Medical Association