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Otolaryngology Coding Alert

Get Up to Speed on the New CMS-1500 Form

Make sure your software is ready to handle the changes

Just when you think you-re prepared for the National Provider Identifier (NPI) conversion, there's another hurdle to clear. You-ll soon be faced with a new version of the CMS-1500 Health Insurance Claim Form. Prepare for 6 Changes Deadline: Starting April 2, 2007, you-ll have to use new version 08-05 of form CMS-1500 to accommodate the new NPI numbers. In addition, a few small, non-NPI-related changes were made -to accommodate special needs,- the National Uniform Claims Committee (NUCC) says. The changes include:

- The bar code at the top of the form was removed.

- Box 17a was shortened. You-ll use this box for ID numbers other than an NPI.

- Box 17b was added. You-ll put the referring physician's NPI here.

- Shaded lines were added to Box 24. This change accommodates NPIs and other ID numbers during the transition period and also allows you to report supplemental information, the NUCC says.

- In Box 24C, -Type of Service- was changed to -EMG.- This is a payer-specific emergency indicator.

- Boxes 32 and 33 were divided into two boxes to accommodate the NPI. Don't miss: In boxes 32 and 33, it is the first part---a---of the box that you-ll use for the NPI number, and box -b- is for other provider ID numbers.

This is the opposite of boxes 17 and 24i, in which the NPI goes after the other provider ID numbers. Verify That Your Software Is Current Contact your vendors now to make sure your software will be able to accommodate the new data fields and allow for printing adjustments. This -will likely be a very costly change for billers and providers because some software vendors will use this as an income avenue,- says Cyndee Weston, executive director of the American Medical Billing Association in Sulphur, Okla.

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