Understanding and correctly applying the date format requirements for the CMS-1500 form is paramount for healthcare providers. Incorrect date entries are a common cause of claim rejections, leading to payment delays and administrative burdens. This comprehensive guide outlines the critical date formatting rules for paper CMS-1500 claims, covering birth dates, service dates, and other key items, to help you avoid unprocessable claims and ensure accurate billing.

These guidelines primarily refer to a specific version of the CMS-1500 form. Always consult the latest official CMS guidelines or payer-specific requirements for the most current information, as formats can change over time.

General Principles for CMS-1500 Paper Claim Dates: CMS 1500 Form Date Entry Rules

When reporting calendar year dates on the Form CMS-1500, adherence to specific formatting instructions is crucial. The primary formats are either 8-digit (MMDDCCYY) or 6-digit (MMDDYY), with distinct rules for spacing depending on the field.

For more insights into general claim submission best practices or preventing common claim errors, explore our other resources.

8-Digit Birth Date Requirements (Items 3, 9b, 11a)

If birth dates are furnished in the specified items below, they must consistently contain an 8-digit format: MMDDCCYY. This includes two-digit months (MM), two-digit days (DD), and four-digit years (CCYY).

• Item 3: Patient’s Birth Date
• Item 9b: Other Insured’s Date of Birth
• Item 11a: Insured’s Date of Birth

When provided, these 8-digit birth dates must be reported with a space between the month, day, and year (i.e., MM_DD_CCYY). On the Form CMS-1500, this spacing is visually represented by a dotted, vertical line.

Example of Correct Birth Date Format: 01 15 1980 (for January 15, 1980)

Example of Incorrect Birth Date Format: 01151980 or 01/15/1980

Handling Unprocessable Claims and Remark Code N329

If a birth date is provided in items 3, 9b, or 11a and is not in the required 8-digit format with spaces, carriers are mandated to return the claim as unprocessable. This often results in remark code N329 on the remittance advice, signifying that the claim was returned because a required date was missing or invalid.

It’s important to understand ‘carrier discretion’ in this context: This means if a carrier doesn’t rely on the incoming claim’s birth date for processing (perhaps they obtain it from another source), they aren’t strictly required to return these claims even if a birth date is reported incorrectly in items 3, 9b, or 11a. However, if the carrier uses the date of birth information from the incoming claim for processing, they must edit and return claims that contain birth date(s) in any of these items that are not in the proper 8-digit, spaced format.

6-Digit vs. 8-Digit Dates for Other Conditional Items (11b, 14, 16, 18, 19)

For several other conditional or required date items on the Form CMS-1500 (items 11b, 14, 16, 18, 19), when dates are provided, either a 6-digit (MMDDYY) or an 8-digit (MMDDCCYY) date may be provided. The key is consistency: if you choose 8-digit dates for any of these items, all completed items within this group (excluding items 12 and 31) must also use the 8-digit format. You cannot mix 6-digit and 8-digit formats across these items on the same claim.

If 8-digit dates are used for these items, they must be reported with a space between month, day, and year (i.e., MM_DD_CCYY), similar to birth dates. The dotted vertical lines on the Form CMS-1500 delineate these spaces.

Example of Correct 8-Digit Format for Item 14 (Date of Current Illness): 03 20 2023

Example of Correct 6-Digit Format for Item 14: 03 20 23

Example of Incorrect Mixed Format: Item 14 as 03 20 2023 and Item 16 as 042523.

CMS 1500 Item 24A Date Format: Service Dates (MMDDCCYY)

Item 24A, which captures service dates, has a unique and critical formatting requirement to ensure accurate processing. This is a common area for questions on how to fill out CMS 1500 dates.

Unlike other date fields, Item 24A must be reported as one continuous 8-digit number (MMDDCCYY), without any spaces between the month, day, and year. By entering a continuous number, the date(s) in Item 24A will naturally penetrate the dotted, vertical lines that are used to separate month, day, and year in other fields.

Carrier claims processing systems are designed to process the claim correctly even if the date penetrates these vertical lines. However, it is essential that all 8-digit dates reported remain within the physical confines of Item 24A.

• No Compression: Do not compress or change the font of the “year” component in Item 24A to force the date within the confines of the box. If a continuous number is furnished without spaces, compression should not be necessary.
• Clear Separation: The “from” date in Item 24A must not run into the “to” date, and the “to” date must not run into Item 24B.
• No Slashes: Dates reported in Item 24A must never use slashes between month, day, and year.

Example of Correct Item 24A Date Format (Service From Date): 06252023 (for June 25, 2023)

Example of Incorrect Item 24A Date Format: 06 25 2023 or 06/25/2023

To further enhance clarity, consider using visual aids such as screenshots or diagrams of the CMS-1500 form, clearly illustrating the correct date entry and spacing (or lack thereof) for each specified item.

FAQ: Common CMS 1500 Date Format Questions

What happens if dates are incorrectly formatted on a CMS 1500 form?

Incorrectly formatted dates, especially birth dates in Items 3, 9b, or 11a, will cause the claim to be returned as unprocessable, leading to delays in payment. Carriers may use remark code N329 on the remittance advice. This means you will need to correct and resubmit the claim, impacting your revenue cycle.

Why is the date format for Item 24A different from other date fields?

The continuous MMDDCCYY format for Item 24A (service dates) is a specific requirement designed for processing efficiency. It ensures that the range of service dates is clearly captured without ambiguity, despite visually ‘penetrating’ the internal dotted lines.

Can I mix 6-digit and 8-digit dates on the same CMS 1500 form?

For items 11b, 14, 16, 18, and 19, you must be consistent. If you choose to use an 8-digit format for any of these items, all completed items in this group must use an 8-digit format. Similarly, if you opt for 6-digit dates, all must be 6-digit. Mixing formats across these conditional items on the same claim is not permitted.