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Eli's Rehab Report

Workers' Comp:

Revealed Common CMS-1500 Form Mistakes That Cause Denials

The devil is always in the details, and when it comes to workers’ comp, it’s often problems with the CMS-1500 form that cause denials, says Trish Bukauskas, a coding and billing expert who recently presented an audio conference for AudioEducator.

The CMS-1500 often goes by its older name — the HCFA-1500 form. No matter what you like to call it, attention to this checklist will ensure that your workers’ comp claims are paid.

  • Make sure that you include signature on file in boxes 12 and 13 on CMS-1500. Note: The date in box 12 must be the same as the date in box 24.
  • Box 21: If the claim spans the time period covering the switch from ICD-9 to ICD-10, you need two separate forms — one for ICD-9 and another for ICD-10.
  • Box 31 needs the signature of the treating provider and the bill date must be after last date of service.
  • Box 33 is the most important of them all — it’s the billing address.

Tip: Save yourself a headache and lots of paper — file electronically and use direct deposit. Not only does this cut paper work and speed the entire process, but it simplifies things when doing follow up because everything you need is stored online.