Updated 1500 Claim Form - 837P Map
August 13, 2018
The NUCC has updated its map of the 02/12 1500 Claim Form to the X12 837 Health Care Claim: Professional (837P) Version 5010/5010A1 electronic transaction. The substantive change in the map is the addition of the 837P REF01 and REF02 data elements in the mapping of 1500 claim form Item Number 19. The map is available under the 1500 Claim Form tab.
The 1500 Claim Form - 837P map is a simplified crosswalk of the 1500 Item Numbers to the corresponding data elements in the 837P 5010/5010A1 transaction. Users of the map will need to refer to the NUCC's 1500 Reference Instruction Manual and the X12 Technical Report Type 3 (TR3) for more information about the data elements and reporting requirements.
1500 Claim Form Renewed by OMB
April 10, 2017
The Office of Management and Budget (OMB) has completed its review and renewed the 1500 claim form for use by government programs, most notably Medicare. The form has been renewed in its current format, with no changes to the OMB number, data fields, or other text on the form.
Forms with the 02/12 NUCC approval date and OMB number 0938-1197 (02-12) remain in effect and valid.
The renewal of the 1500 claim form by OMB occurs every three years and is outside the scope of the NUCC's work.
Questions about the DSMO Process?
The Designated Standards Maintenance Organizations (DSMO) have created a presentation "Understanding the HIPAA Processes" to provide information on the HIPAA transactions, code sets, and operating rules processes under HIPAA. The presentation was developed to satisfy an industry need to have in one concise document the process of how to request changes to HIPAA mandated standards.
The presentation is available here: DSMO: Understanding the HIPAA Process
The DSMO includes three American National Standards Institute (ANSI) Accredited standard development organizations ‐ Accredited Standards Committee (ASC) X12, Health Level Seven (HL7) International, and the National Council for Prescription Drug Programs (NCPDP), and three data content organizations ‐ the American Dental Association (ADA) Dental Content Committee (DeCC), National Uniform Billing Committee (NUBC), and National Uniform Claim Committee (NUCC). The DSMO reviews change requests to the HIPAA designated standards and requests for new standards and code sets to be adopted.
Resources for Implementing the 02/12 1500 Claim Form
Payers may begin accepting the 02/12 1500 Claim Form as of January 6, 2014. The following resources will assist your organization in implementing the revised form:
- Understanding the Changes to the 0212 1500 Claim Form presentation
- Updating to the 0212 1500 Claim Form
Submitters of the form should follow up with their specific payer(s) regarding their transition timeline information.
January Release of Updates to Provider Taxonomy and Provider Characteristics Code Sets
January 2, 2019
The NUCC has released the semi-annual update to the Health Care Provider Taxonomy code set, which will go into effect on April 1, 2019. The complete code set is available under the "Code Sets" tab. The PDF download version of the code set is also available there.
When reviewing the Health Care Provider Taxonomy code set online, revisions made since the last release can be identified by the color code; new items are green.
Additionally, four new codes have been added to the Provider Characteristics code set. The complete code set is available under the "Code Sets" tab. These new codes are effective for use on April 1, 2019.