Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident

With many providers submitting paper claims due to the Change Healthcare security incident, it is important to submit your claims correctly. Failure to do so will result in the claims being returned to you.

Recently, we are seeing errors that cause claims to be returned. Here are some important reminders:

• All paper claims are required to be submitted using an original red/white CMS-1500 (02/12) form.
• Photocopied claims are not acceptable and will be returned. Black and white copies will be returned as unprocessable.
• Submission of the CMS-1500 (02/12) claim form should either be typed or computer printed forms.
• National Government Services will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13 or 31).
• Box 1: Enter the patient’s Medicare MBI. The new term “Medicare number” and “Medicare ID” as it appears on the patient’s red, white and blue Medicare card for all Medicare claim submissions (primary or secondary). The MBI is 11 characters in length and made up only of numbers and uppercase letters (no special characters); if you use lowercase letters, our system will convert them to uppercase letters. MBIs are assigned by SSA and CMS. See CMS IOM Publication 100-01, Medicare General Information, Eligibility, and Entitlement Manual, Chapter 2.
• Box 24A: Enter a six-digit (MM/DD/YYYY) or an eight-digit date (MMDDCCYY) for each procedure, service, or supply. “From” and “to” dates should be consecutive days for a series of identical services and should equal the number of days or units in Item 24G.
• Box 24B: Enter the appropriate two-position POS code to identify the location where the Item is used or the service is performed. You may refer to CMS website for Place of Service Codes for Professional Claims.
• Box 24D: Medicare requires completion of this portion of the Item. Enter the appropriate CMS CPT/HCPCS code. When applicable, show CPT/HCPCS code modifiers with the CPT/HCPCS code. The CMS-1500 claim form (02/12) has the ability to capture up to four modifiers.
• Box 32: Location where the service was rendered is required for all POS codes, including patients home and claims with services payable under the MPFS. Only one name, address and ZIP code may be entered. ZIP code must be complete and accurate.

Our Provider Outreach and Education staff offers training on claim completion.

Visit our Events page to view all upcoming education.

Related Content

We have instructions on our website for completing Medicare paper claim forms. We’ve listed links to information that will help you submit your claims correctly and avoid processing delays.

• CMS-1500 Claim Form Completion Instructions
• General Information
• Claim Filing Instructions for Paper and Electronic Submission
• Regulations on Charging for Claim Form Completion
• Optical Character Recognition System
• Missing, Incomplete, Insufficient or Invalid Claim Information
• Health Insurance Claim CMS-1500 Form (02/12)
• Patient and Insured Information
• Medicare Part B CMS-1500 Crosswalk for 5010 Electronic Claims
• Medicare Billing Fact Sheet for Electronic (837P) and Paper (Form CMS-1500) Claims
• Handwriting on Claims Submitted to Medicare
• Date of Service on CMS-1500 Billing
• Unprocessable Claim Rejections and Corrections
• MLN® Fact Sheet: Medicare Billing: 837P and Form CMS-1500 Fact Sheet

Posted 4/17/2024