CMS-1500 Claim Form Instructions

Need help with your CMS-1500 Claim Forms?

Check out CMS-1500 Claim Form Instruction guide produced by NHIC highlighting the following:

• Instructions for Filling Out the Health Insurance Claim CMS Form-1500 
• Appendix A – Sample Wording For Authorization  & Appendix B - Place of Service Codes with Definitions 
• National Correct Coding Initiative (NCCI)
• Medically Unlikely Edits (MUEs)
• Limitation of Liability (Advance Beneficiary Notice)
• Local Coverage Determination (LCD) & National Coverage Determination (NCD) 
• Medicare Fraud and Abuse
• Recovery Audit Contractor (RACs)
• Comprehensive Error Rate Testing (CERT)
• Provider Enrollment Help Line/Provider Enrollment Status Inquiry Tool
• Mailing Address Directory
• Provider Services Portal (PSP)
• Durable Medical Equipment (DME)
• Reconsideration (Second Level of Appeal)
• Additional Resources to fill out your claim forms

To download and view the instruction guide, please click here: CMS-1500 Claim Form Billing Instructions

Ensure You're Billing Your Place of Service (POS) Codes Correctly

In medical coding and billing, place of service (POS) codes are two digit codes that specify where the patient received their treatment.  To ensure you are appropriately receiving payment, using the correct POS code is crucial.

According to the Centers for Medicare and Medicaid Services (CMS), incorrect billing of the POS code may result in over-payments to the physician and may also change the amount you are reimbursed by Medicare.

Billing the incorrect POS code may also cause your practice to face issues with the OIG (Office of Inspector General) as they have been reviewing correct POS coding in more detail over the past couple of years.

The following guideline, Place of Service Codes Guideline explains the POS codes and the descriptions for these codes as well as whether or not the pay rate is for a facility (F) or non-facility (NF).

To download and view the full guideline, please go to the following link: Place of Service Codes Guideline.