All changes that were made to the instructions following the July release have been incorporated into this version of the instruction manual. The results of the survey are available here. The NUCC conducted a survey from October to November to gather information on the current usage in the industry of the Health Insurance Claim Form Form , both as a paper form and as a print image.
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Questions or comments about the code set or the revisions can be emailed to: The Office of Management and Budget OMB has completed its review and renewed the claim form for use by government programs, most notably Medicare. Additionally, seven changes have been made to the Provider Characteristics code set; six new coaim have been added and one code has been revised.
1500 Claim Form Reference Instruction Manual
The form has been renewed in its current format, with no changes to the OMB number, data fields, or other text on the form. A change log showing all of the updates is also available under the Claim Form tab. Through an iterative process, the NUCC used existing implementation guides, data dictionaries and results from ongoing standardization efforts within the health care industry to consolidate the many current data sets into one set. The presentation is available here: As such, the NUCC is intended to have an authoritative voice regarding national standard content and data definitions for non-institutional health care claims in the United States.
The form image may not print to scale.
The results of the survey are available here. The top reasons for using the Form among all stakeholders were 1 attachments; 2 coordination of benefits; 3 for, compensation, property and casualty, and auto claims; 4 claims for specific services; and 5 primary claims.
National Uniform Claim Committee - Home
This survey is not an indication of any specific changes being considered for the Form. To request changes to the Claim Form layout, please fill out the form below and email it to This email address is being protected from spambots.
The NUCC is comprised of the key parties affected by health care electronic data interchange EDI - those at either end of a health care transaction, generally payers and providers. This email address is being protected from spambots. Overall, the survey found that there continues to be significant use of the Form within the industry.
The result is a very labor-intensive and costly business practice for providers and payers. The presentation was developed to satisfy an industry need to have in one concise foorm the process of how to request changes to HIPAA mandated standards. Questions about the map can be sent to: The following resources will assist your organization in implementing the revised form: The NUCC continues to work to optimize, as necessary, coordination of implementation within the health care industry, working with ASC X12N as required, to resolve data maintenance and standards problems that arise from the NUCC's work.
This email address is being protected clwim spambots.
The NUCC does not process claims. From the payer 5100, claims that are not in the required format may be resubmitted several times before they can be processed.
The NUCC does not process claims. If you have any questions about the survey or results, please email This email address is being protected from spambots.
With the transition of the medical community to electronic data interchange and the proliferation of data element definitions among various payers, it became essential that an organization be established to maintain uniformity and standardization nuc these areas.
The updated instruction manual, Version 6.