New HCFA Forms Coming 2014

September 10, 2013 in Managing Your Practice

New HCFA form coming to your private practice

Along with the joy of the new ICD-10-CM codes we’re all so looking forward to, it’s time to start planning for a new and improved CMS-1500 claim form that allows for the new coding. Even if you run a primarily a paperless practice, you should be aware of this transition to new HCFA forms and new code sets in 2014.

So what’s changing?

  • That old red HCFA we all know and love so well is getting a face lift to make room for expanding the number of diagnosis codes (up to 12 on the new form).
  • They’ve also made space to differentiate between the role a provider plays for a patient– supervisor, referrer, ordering physician, etc.
  • They’ve created a way to differentiate between ICD-9-CM and ICD-10-CM codes during the transition between the code sets.
  • For a peek at a sample of the revised form, I’m including a link to the National Uniform Claim Committee’s website .

    What should you do to prepare?

  • First of all, be aware of the new ICD code sets. If you wish to receive insurance reimbursement you will have to use the ICD coding when you submit either paper or electronic claims. (More info about the ICD-10 codes is available at CMS.gov..)
  • Make sure your billing software is upgraded to handle the new coding.
  • Don’t order cases of the old-style forms now. Monitor your stock and order just enough to get you through until the new form is implemented.
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    Here’s what the Center for Medicare Services is saying their current timeline is for the implementation of the new form:

  • January 6, 2014- Medicare will begin accepting the new form.
  • January 6, 2014 through March 31, 2014- Medicare will accept both the old-style CMS 1500 and the new form.
  • April 1, 2014- Medicare, and many commercial payers, will accept the new form and the new form ONLY. Beginning on this date, using the old-style form will result in claim denials if submitted to Medicare. Check with your individual payers to see which form they will accept as they transition to the new form- some will have upgraded their systems as of April 1st and some may have not.
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