Where is the diagnosis pointer on a CMS-1500?
The diagnosis pointers are located in box 24E on the paper claim form for each CPT code billed. The line identifiers from Box 21 (A-L) should be related to the lines of service in 24E by the letter of the line.
How many diagnosis pointers can be used for each CPT code on the CMS-1500?
Up to twelve diagnoses can be reported in the header on the Form CMS-1500 paper claim and up to eight diagnoses can be reported in the header on the electronic claim. However, only one diagnosis can be linked to each line item, whether billing on paper or electronically.
How are diagnosis pointers used?
What are Diagnosis Pointers?
- Hover your cursor on Billing > Live claims Feed.
- Click on the appointment and it will take you to the Billing Detail Screen.
- Enter the ICD-10 codes and CPT codes on the appointment.
What is diagnosis pointer on HCFA?
Diagnosis code pointers are used to indicate the appropriate order of importance in relation to the service being performed. The first pointer designates the primary diagnosis for the service line. Remaining diagnosis pointers indicate declining level of importance to service line.
How many possible diagnosis codes can be recorded on a CMS-1500 form?
12 diagnosis codes
The 5010 and CMS-1500 forms were modified to support up to 12 diagnosis codes per claim (while maintaining the limit to four diagnosis code pointers) in an effort to reduce paper and electronic claims from splitting.
What should be entered in field 24E of the CMS-1500 claim?
Item 24E – This is a required field. Enter the diagnosis code reference number or letter (as appropriate, per form version) as shown in item 21 to relate the date of service and the procedures performed to the primary diagnosis. Enter only one reference number/letter Page 17 per line item.
How many possible diagnosis codes can be recorded on a CMS 1500 form?
What goes in box 24E on CMS 1500?
Box 24e is used to indicate the line letter from Box 21 that relates to the reason the service(s) was performed. When multiple services are performed, the primary reference letter for each service should be listed first. There can be up to 4 pointers on each service line.
What goes in box 23 on a CMS-1500?
Box 23 is used to show the payer assigned number authorizing the service(s).
How many DX codes can be billed?
Although twelve diagnosis codes are allowed per claim, only four diagnosis codes are allowed per line item (each individual procedure code). ONLY four (4) diagnosis codes may connected (pointed) to each procedure.
What is Box 24E on CMS 1500?
What is the maximum of ICD codes that can be entered on a CMS-1500 form as of Feb 2012?
Expanded to accept up to twelve diagnosis codes that may be a maximum of seven characters in length. Requires an indicator to specify if the diagnosis codes used are ICD-9-CM (indicator “9”) or ICD- 10-CM (indicator “0”) codes. Claims may not contain both ICD-9 and ICD-10 codes on the same claim form.