CMS-1500 Claim Form

1. Form overview and versions

   Form version 02/12, fields 1 to 33, NUCC ownership and CMS use.

2. Medicare completion instructions

   Item-by-item instructions for CMS-1500 including payer, insured and patient items.

3. Diagnosis codes and pointers

   Item 21 ICD indicator and codes A to L, and item 24E diagnosis pointers.

4. Service lines item 24

   Dates of service, place of service, CPT/HCPCS and modifiers, charges, units and rendering NPI.

5. Provider items

   Billing provider, rendering provider, referring provider, NPI, TIN and taxonomy qualifiers.

6. Place of service

   Two-digit place of service codes in item 24B.

7. Mapping to 837P

   How paper CMS-1500 fields map to 837P loops and segments.

Each section links to the official page. Titles and summaries by Extra Credit; the docs belong to their authors.