Medicare Claims Processing Manual

Medicare Claims Processing Manual Chapter 26 - Comple ting and Proce ssing Form CMS-1500 Data Set Table of Conte nts (Rev. 3881, 10-13-17) Transmittals for Chapter 26 10 - Health Insurance claim Form CMS-1500 - Claims That Are Incomplete or Contain Invalid Information - Items 1-11 - P atient and Insured Information - Items 11a - 13 - P atient and Insured Information - Items 14-33 - P rovider of Service or Supplier Information - Place of Service Codes (P OS) and Definitions - A/B Medicare Administrative Contractor (MAC) (B) instructions for Place of Service (POS) Codes - Type of Service (TOS) - Requirements for Specialty Codes - Assigning Specialty Codes by A/B MACs (B) and DME MACs - P hysician Specialty Codes - Nonphysician P ractitioner, Supplier, and P rovider Specialty Codes - Miles/Times/Units/Services (MTUS) - Methodology for Coding Number of Services, MTUS Count and MTUS Indicator Fields 20 - Patient s Request for Medicare Payment Form CMS-1490S 30 - P rinting Standards and P rint File Specifications Form CMS-1500 Exhibit 1 - Form CMS-1500 (08/05) User P rint File Specifications (Formerly Exhibit 2) 10 - Health Insurance claim Form CMS-1500 (Re v.)

Medicare Claims Processing Manual . Chapter 26 - Completing and Processing . ... These instructions represent the minimum requirements for using this form to submit a

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