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On March 9, 2007, the Centers for Medicare and Medicaid Services CMS announced that certain print vendors, specifically the Government Printing Office (GPO), are selling incorrectly formatted versions of the revised form. The National Uniform Claim Committee (NUCC) revised the CMS-1500 (12-90) last July to accommodate the NPI. Medicare announced in September 2006 that beginning April 1, 2007, it would accept only the new form, CMS-1500 (08-05). If a provider has obtained updated CMS-1500 forms from the GPO or other vendors offering a similar form to accommodate the National Provider Identifier (NPI), the forms may not be valid.
According to the official CMS press release, “After reviewing the situation, the GPO has determined that the source files they received from the NUCC’s authorized forms designer were improperly formatted. This resulted in the sale of both printed forms and negatives which do not comply with the form specifications.”
In recognition of this massive potential snag, CMS has announced that they will extend the CMS-1500 (12-90) version acceptance period beyond the original April 1, 2007, deadline while the situation is resolved. “Medicare contractors will be directed to continue to accept the Form CMS-1500 (12-90) until notified by CMS to cease,” CMS said, estimating a target date of June 1, 2007.
CMS is directing contractors to return any CMS-1500 (08-05) forms they receive that are not printed to specification. For more information on identifying correct and incorrect forms, visit: www.cms.hhs.gov/ElectronicBillingEDITrans/Downloads/1500%20problems.pdf or contact Brian Reitz at Brian.Reitz@cms.hhs.gov.
The CMS website, http://www.cms.hhs.gov/ElectronicBillingEDITrans/16_1500.asp, provides the following description of the Form 1500 and its intended use:
“The National Uniform Claim Committee (NUCC) is responsible for the maintenance of the CMS-1500 form. CMS does not provide the form to providers for claim submission. In order to purchase claim forms, you should contact the U.S. Government Printing Office at (202) 512-1800, local printing companies in your area, and/or office supply stores. Each of these sources sells the CMS-1500 claim form in its various configurations (single part, multi-part, continuous feed, laser, etc).
The only acceptable claim forms are those printed in Flint OCR Red, J6983, (or exact match) ink. Although a copy of the CMS-1500 form can be downloaded, copies of the form cannot be used for submission of claims, since your copy may not accurately replicate the scale and OCR color of the form. The majority of paper claims sent to Medicare contractors are scanned using Optical Character Recognition (OCR) technology. This scanning technology allows for the data contents contained on the form to be read while the actual form fields, headings, and lines remain invisible to the scanner. Photocopies cannot be scanned and therefore are not accepted by Medicare contractors.”
ICA’s Medicare Committee will continue to monitor this and other developments and keep the membership fully informed.
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