General Surgery Coding Alert

You-ll likely have to make software changes, so get started now

By April 2007, you-ll have to have started using the new form to accommodate the new National Provider Identifier (NPI) numbers.

Because of the number and types of changes that the new CMS-1500 includes, you will need to update your billing software programs to print your claims correctly, says Cyndee Weston, executive director of the American Medical Billing Association. That means now is the time to update your billing system software to ensure your office is ready.

Expect a 3-Month -Grace Period-

CMS stated in Transmittal 1010, released on July 28, that the new 1500 form implementation will be effective Jan. 1, 2007. The new CMS-1500 form will be available to use starting on that date. You won't be required to use the new form, however, until April 2, 2007.

According to CMS, during the transition period, carriers will accept both current and revised forms -- meaning you can use either the new version (08-05) or the version you-re now using (12-90) as follows:

- Jan. 2-March 30: You can use either the current form (CMS-1500, 12-90) or the revised form (CMS-1500, 08-05). -Health plans, clearinghouses, and other information support vendors should be able to handle and accept the revised Form CMS-1500 (08-05) by Jan. 2, 2007,- CMS states in MedLearn Matters article MM5060.

- After April 2: You will only be allowed to use the new CMS-1500 form. This includes any resubmission of bills that you need to handle after April 2.

Best bet: Talk to your software vendor or clearinghouse as soon as possible. Find out what it intends to do to address the changes and when you can expect upgrades to occur. Get the timeline from your vendor in writing to ensure that it delivers when it says it will. Knowing what to expect and when you can expect it will help make the transition less painful.

See the new CMS-1500 at www.nucc.org/images/stories/PDF/final_1500_claim_form.pdf.