# CMS 1500 claim form



## angnel1 (Sep 18, 2015)

I work in obstetrics and have taken an ICD10 course. When you add the weeks of gestation to an obesity complication and advanced maternal age (for example) there are more than 4 diagnosis codes to map to the e/m. Does the new CMS 1500 form allow for this. I pulled an example and it reads that it can but our system is only allowing us to map 4 diagnosis codes even for ICD 10. Is this a glitch with our system or are we still supposed to only code 4 diagnosis codes to the CPT. Hope this makes sense....need help!


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## philipwells (Sep 18, 2015)

The CMS 1500 (02-12) has enough room on the claim for 12 diagnoses. If your software is only allowing 4 then it will be an issue with them. Hopefully they will have an update really soon, like 3 months ago = /


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## mitchellde (Sep 18, 2015)

angnel1 said:


> I work in obstetrics and have taken an ICD10 course. When you add the weeks of gestation to an obesity complication and advanced maternal age (for example) there are more than 4 diagnosis codes to map to the e/m. Does the new CMS 1500 form allow for this. I pulled an example and it reads that it can but our system is only allowing us to map 4 diagnosis codes even for ICD 10. Is this a glitch with our system or are we still supposed to only code 4 diagnosis codes to the CPT. Hope this makes sense....need help!



You can list a maximum of 12 diagnosis per claim, however you are allowed to link only 4 per line item.  There is no way around this, so the instructions state to link only the pertinent 4 for any given service (line item ) performed.


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## angnel1 (Sep 19, 2015)

*Mapping*

Thank you for your help with this. Are there certain codes that are required for ICD 10 that need to be  mappled when it comes to obstetrics? I know the weeks of gestation needs to be on the claim but if a patient is high risk and the codes out number the CPT allowance of 4 how do we know it won't get rejected by the insurance company. I guess I was under the impression with ICD 10 we would be able to map more to the CPT code. I know the form can hold 12 but if you don't map it how does it get on the claim form??


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## lizelder (Sep 30, 2015)

*Billing manager, CPC*

After speaking with my tech support people today (because I had the same concern), I found a way for all dx to appear on the claims, but they will be unmapped. I don't know if this will be sufficient specificity to satisfy payers.  Does anyone know if it will be enough that they are on the claim?


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## tmcquegge (Oct 2, 2015)

*so stupid*

We have been researching this today as well because we thought with ICD-10 we would be able to link more DX's per line.  Whats the point to all of this if only 4 DX's are still going to go.  you still can't give a complete picture of what the physician is doing...


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## wonder1963 (Feb 11, 2016)

*Cms 02/12*

You have to submit ANSI 5010 or CMS version 02/12 as of 10-1-15 this will allow up to 12 dx, each service line can point up to 4 of those (does not have to be the same 4 on each line) dx . hope this helps


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