March 27, 2014
CMS-1500 Claim Form: Revised
Effective 04/01/2014, Medicare is no longer accepting paper claims on the old CMS 1500 claim form with a date of 08-05 in the lower right hand corner. The new form has a date of 02-12. Qualifiers to identify an ordering, referring, or supervising role should be entered to the left of the dotted vertical line on item 17. ICD Indicator should be entered on item 21 ICD Ind. Diagnosis codes should be entered in the correct order through A-L on item 21. Diagnosis Pointers should be alpha characters A-L on item 24E.
For more information, please refer to CMS MLN Matters article MM8508, "CMS 1500 Claim Form Instructions: Revised for Form Version 02/12."