Straight Talk About the New 1500 Form and ICD-10 Diagnosis Codes

Unless you have been blessed to be on sabbatical in the Himalayas for a couple of years, you've undoubtedly heard of the new 1500 form changes required by the government.  The good news is, ClientTracker is ready for these changes, and will make dealing with them a LOT easier!

The New 1500 Form is Required for Use as of April 1, 2014
The new version is called the HCFA CMS-1500 Claim Form, version 02-12.  The changes were a long time coming, and were mandated by the Center for Medicare Services (CMS) and the National Uniform Claims Committee.  We at Ginkgo Software had noting to do with requiring these changes, and our bliss is to make it easier for you to deal with!

Click here to view our new video introducing the new form and some new features to make it easier!

The primary change on the new form is to allow for up to 12 diagnosis codes in Box 21, to accommodate the larger code sets that will eventually be required for ICD-10.  However, use of the new ICD-10 Codes will not be allowed on this new form until October 1, 2015 (current timeline).

NUCC Timeline Governs Usage of the New 1500

• The official NUCC timeline for the new form specifies that you may use either the old or new form through March 31 (which is just 6 weeks away as of this post).
• The new 02-12 version will be REQUIRED by clearing houses and payers nationwide, starting April 1, 2014.  Any claims submitted using the old 08-05 version will be rejected.
• The new 1500 allows for use of the new ICD-10 Diagnosis Codes, which are not to be used  now but will be required on October 1, 2015.
  
• ClientTracker will have another update before then, with new features to make the transition to ICD-10 as easy as possible for you.

The New ICD-10 Codes Will Be A HUGE CHANGE
If you haven't learned about the new ICD-10 codes yet, you still have lots of time until they are required.  When required, they will profoundly change how you interact with patients, payers, legal issues, and other health care providers.

ICD-10 codes are not "new," except in this country.  The rest of the world has been using these codes for decades, and the U.S. will have to start using them eventually! 

• (Update April 2014)  Strong protests from AMA and other lobbies have pushed back the compliance date for ICD-10 to October 1, 2015.

Future Think
If you are not prepared to use these new diagnosis codes, it will take MUCH LONGER to code a visit and provide a valid superbill to your patients!  If you bill insurance directly, it's even more imperative that you use the new codes properly.  And of course you want to present a professional image as a healthcare provider, even if you do not deal with insurance at all!

If your patients do not have proper diagnosis codes provided by you, they may not be reimbursed by their insurance, and some will seek other healthcare options so they don't have to pay out-of-pocket!

Watch for more information in this blog and other Ginkgo Software resources.