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Please be advised that the CMS-1500 Form (version 02/12)
has been recently revised and will be in effect starting
January 6, 2014. |
The CMS-1500 Form was revised
to accommodate reporting needs for ICD-10 and to align
with requirements in the ASC X12 Health Care Claim:
Professional (837P) Version 5010 Technical Report Type
Two priorities that were included in the
revisions to the CMS-1500 Form include:
indicator in Item Number 21 to identify the version of
the diagnosis code set being reported, i.e., ICD-9 or
ICD-10. The need to identify which version of the code
set is being reported will be important during the
implementation period of ICD-10.
2. The second
priority was to expand the number of diagnosis codes
that can be reported in Item Number 21, which was
increased from 4 to 12.
To see a listing of the
complete Claim Form Change Log, CTRL + click on the
2014: Payers begin receiving and processing paper claims
submitted on the revised CMS-1500 form (version 02/12).
ICD-9 codes are to be used for services provided before
October 1, 2014. (To view the SAMPLE CMS-1500 revised
form, CTRL + click on the following link:
•January 6 through March 31, 2014: Dual use period
during which payers will continue to receive and process
paper claims submitted on either the old CMS-1500 form
(version 08/05) or the revised CMS-1500 form (version
02/12). ICD-9 Codes must be used for services provided
before October 1, 2014.
•April 1, 2014: Payers
will begin to receive and process paper claims submitted
only on the revised CMS-1500 form (version 02/12). ICD-9
Codes must be used for services provided before October
•October 1, 2014: For services provided
on or after October 1, 2014, healthcare providers must
use ICD-10 Codes.
It is recommended that
healthcare providers engage in a dialogue with payers as
to their implementation timeframes regarding the
transition to ICD-10.
The Commission is proud to
announce that the Maryland Workers’ Compensation
Educational Association has awarded the 2013 Alfred M.
Porth Memorial Award to Thomas P. O’Reilly, former
Chairman of the Workers’ Compensation Commission.
The name installation ceremony for the Porth Award
plaque will be held on Thursday, October 17, 2013 at
2:45 p.m. in the 4th floor lobby of the Commission.
Effective October 1, 2013
the Injured Workers’ Insurance Fund (IWIF) becomes
Chesapeake Employers’ Insurance Company. All
Commission correspondence and online information will
bear this name with the exception of Maryland state
employees. State employees’ claim information will
note State of Maryland as the Insurer in all
correspondence and online information. Insurer
Designee contact information
for both listings will be the same individual.
Chesapeake Employers' Insurance Company's new web
questions regarding the name change as applicable
Workers' Compensation Commission claims can be directed
to our Public Service office via email
email@example.com or our general telephone
number, (410) 864-5100.