CMS-1500 (02-12) Claim Form Must Be Used Effective May 3, 2014
Due to updates to field instructions, providers are encouraged to review the CMS-1500 (02-12) Claim Form Instructions.
- In Field 24E, the Diagnosis pointers must be alpha characters.
- In Field 30, the space is labeled as reserved for NUCC use, but the Balance Due is required.
Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes, descriptions and data are copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. AMA and ADA assume no liability for data contained or not contained on this website and on documents posted herein.
CPT is a registered trademark ® of the AMA. CDT is a registered trademark ® of the ADA. Applicable FARS/DFARS apply.
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