Transcription of Medicare Claims Processing Manual
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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)
Providers may use these instructions to complete this form. The CMS-1500 claim form has space for physicians and suppliers to provide information on other health insurance.
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National Uniform Claim Committee, 1500 Claim, 1500, Claim form, 1500 Claim Form, Instructions for Completing the CMS 1500 Claim Form, Form 1500, 1500 Paper Claim Form Crosswalk to, 1500-Health Insurance Claim Form, FORM, Claim, 02/12) CLAIM FORM INSTRUCTIONS, Claim Form Billing Instructions CMS-1500, Health Insurance Program HEALTH INSURANCE CLAIM