Paper CMS 1500 claim changes update MVP insurance

MVP Health Care has developed this guide to help orient you to the key data fields that are changing on the new CMS-1500 Paper Claim Form that will be accepted by MVP Health Care starting 10/1/06 and mandatory beginning 4/1/07. The following example illustrates the changes between the HCFA-1500 claim form and the MVP Health Care data requirements on the new CMS-1500 paper claim form.

MVP Health Care Data Field Changes on CMS-1500 Paper Claim Form

CMS- 1500 Box                                  Submission Requirement


Box 24a-h Shaded Lines                  Use the shaded lines above the service lines for:  Anesthesia start/stop times  Other service line information ( e.g. descriptions for unspecified codes )

Box 24i*                                 Use the shaded space above “NPI” to report qualifier ZZ when reporting Rendering Taxonomy in the shaded space in the top half  of Box 24j

Box 24j*                                  Use the shaded space above the NPI to report Rendering Taxonomy

Box 33a                                    NPI                            
Box 33b                                   Taxonomy code (preceded by ZZ qualifier)