Author Topic: FIELD 14 ON CMS1500 FORM NEED HELP  (Read 7157 times)

KARREN

  • Jr. Member
  • **
  • Posts: 70
FIELD 14 ON CMS1500 FORM NEED HELP
« on: April 07, 2010, 12:31:35 PM »
HOW OFTEN SHOULD THE ILLNESS DATE CHANGE IN FL14?

DETAILED QUESTION:
EACH TIME THE DOCTOR CHANGES THE DX SHOULD FL 14 DATE CHANGE AS WELL.

EXAMPLE:  NEW PT ON 1/1/2010 DR. DIAGNOSIS= 723.1,724.1,728.85.  FL 14 SHOULD REFLECT 1/1/10.
NOW ON 2/15/10 DR RE-EXAM PT &  NEW DX ARE GIVEN 353.1,719.46,729.1  NOW SHOULD FL 14 REFLECT NEW DATE OF 2/15/10
OR SHOULD IT STILL REMAINS 1/1/2010.. 

DMK

  • Hero Member
  • *****
  • Posts: 680
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #1 on: April 07, 2010, 02:32:13 PM »
Field 14 should reflect the CURRENT date of injury.  If the doctor changes the DX it's a new DOI.

medauthor

  • Full Member
  • ***
  • Posts: 129
    • Professional Medical Billers Association
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #2 on: April 09, 2010, 11:34:11 AM »
Personally, I do not use block 14 unless it is req for the claim I am billing....Go ahead billers and yell, I'm ready!  ;)
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

PMRNC

  • Hero Member
  • *****
  • Posts: 4562
    • One Stop Resources & Networking for Medical Billers
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #3 on: April 09, 2010, 06:31:09 PM »
No Yelling here but am curious what you do when the carrier requires it. If I leave it blank it gets rejected at clearinghouse.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

medauthor

  • Full Member
  • ***
  • Posts: 129
    • Professional Medical Billers Association
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #4 on: April 10, 2010, 01:32:37 AM »
I didn't mean when the carrier requires it, I meant when the situation requires so i.e. date of injury, LMP for preg claims, acc date.....

My clearinghouse does not reject if left blank; I use Office Ally.
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

Medical Billing Forum

Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #4 on: April 10, 2010, 01:32:37 AM »

Pay_My_Claims

  • Guest
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #5 on: April 10, 2010, 02:20:39 AM »
Personally, I do not use block 14 unless it is req for the claim I am billing....Go ahead billers and yell, I'm ready!  ;)

I use it more with the custom Rehab DME billing that I do than physician billing (other than accident or pregnancy). This is only because most of our clients either had an injury or they want the date of dx for the condition that confined them.

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #6 on: April 11, 2010, 04:02:10 PM »
I also don't use unless required.  I've never had any clearing house rejections.  Unless it was required and we omitted it.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

cconter

  • Newbie
  • *
  • Posts: 14
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #7 on: April 15, 2010, 09:27:21 AM »
I also don't use it, unless there's been a specific date of accident, i.e. PIP or WC. Clearinghouse has never rejected.   Only one insurance company has ever pended a claim, requesting DOI (CIGNA).   As a chiropractic office, so many of our patients' conditions are insidious or gradual in nature.

Priyan

  • Newbie
  • *
  • Posts: 31
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #8 on: April 21, 2010, 09:54:47 AM »
Chiropractic services requires Date Onset(Date on which illness identified).

This will change based on the diagnosis relativity.
Priyan.D
Pleasure in Job, brings Perfection in work

Christy

  • Sr. Member
  • ****
  • Posts: 320
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #9 on: January 16, 2014, 11:18:46 AM »
pulling up an old thread here:

do any carriers absolutely require box 14 (besides Medicare for certain specialties...)? I used to fill this out as a rule and if the date was not available, just use the date of the initial visit. I wonder if it's better to leave it blank?

I get when the date is needed for pregnancy or an accident. But what about for example- neck pain that slowly creeps in, or headaches? I used to think that box 14 was also used to determine preexisting conditions, maybe I am wrong about that?

I recently billed for acupuncture for neck pain and filled in box 14. A questionnaire was sent to the patient for more details about the "injury". There was no injury and box 10 was all "no." BCBS told the patient that something in the "paperwork" that was sent (we filed an electronic claim) flagged the claim. I was wondering if the culprit was box 14?

any feedback/input/ experiences would be helpful and appreciated!

thanks!
« Last Edit: January 16, 2014, 11:34:44 AM by Christy »

Medical Billing Forum

Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #9 on: January 16, 2014, 11:18:46 AM »

Merry

  • Sr. Member
  • ****
  • Posts: 362
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #10 on: January 16, 2014, 05:44:23 PM »
Any way the carrier can question you they will. So it probably flagged with the dx as a possible accident such as an auto accident. Just my thoughts.

Merry

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #11 on: January 16, 2014, 07:20:55 PM »
I personally only use that field when it is appropriate and/or required.  I leave it blank whenever not required.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Christy

  • Sr. Member
  • ****
  • Posts: 320
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #12 on: January 28, 2014, 03:16:50 PM »
thanks, all! I truly value your input!

rdmoore2003

  • Hero Member
  • *****
  • Posts: 631
  • Live Life and Love God
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #13 on: January 28, 2014, 06:45:40 PM »
I only use this for workers comp.

shanbull

  • Full Member
  • ***
  • Posts: 176
Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #14 on: January 28, 2014, 07:01:33 PM »
We only use it for our auto/workers comp cases as well. I think it's really only intended for liability purposes. State of accident will also flag the claim as the liability of no-fault or worker's comp insurance, which is annoying to sort out even when the case really is due to an auto or worker's comp injury. Especially because auto and worker's comp insurance likes to drag out their decision time-frame as long as they possibly can, well past normal timely filing limits, so we end up having to submit an appeal over that too. Certain ICD codes will do the same thing if the diagnosis is arguably related to trauma. For example, a regular old thoracic vertebra dislocation (839.21) is fine, but if you submit a thoracic sprain instead (847.1) the claim will be flagged. Insurers loooove to get nitpicky about CTL diagnoses.
« Last Edit: January 28, 2014, 07:07:13 PM by shanbull »

Medical Billing Forum

Re: FIELD 14 ON CMS1500 FORM NEED HELP
« Reply #14 on: January 28, 2014, 07:01:33 PM »