Medical Billing Forum

Billing => Billing => Topic started by: KARREN on April 07, 2010, 09:31:35 AM

Title: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: KARREN on April 07, 2010, 09:31:35 AM
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.. 
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: DMK on April 07, 2010, 11:32:13 AM
Field 14 should reflect the CURRENT date of injury.  If the doctor changes the DX it's a new DOI.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: medauthor on April 09, 2010, 08:34:11 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!  ;)
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: PMRNC on April 09, 2010, 03:31:09 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.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: medauthor on April 09, 2010, 10:32:37 PM
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.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Pay_My_Claims on April 09, 2010, 11:20:39 PM
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.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Michele on April 11, 2010, 01:02:10 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
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: cconter on April 15, 2010, 06:27:21 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.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Priyan on April 21, 2010, 06:54:47 AM
Chiropractic services requires Date Onset(Date on which illness identified).

This will change based on the diagnosis relativity.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Christy on January 16, 2014, 08:18:46 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!
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Merry on January 16, 2014, 02:44:23 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
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Michele on January 16, 2014, 04:20:55 PM
I personally only use that field when it is appropriate and/or required.  I leave it blank whenever not required.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Christy on January 28, 2014, 12:16:50 PM
thanks, all! I truly value your input!
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: rdmoore2003 on January 28, 2014, 03:45:40 PM
I only use this for workers comp.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: shanbull on January 28, 2014, 04:01:33 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.
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: Christy on January 28, 2014, 04:49:32 PM
many thanks to you both! :)
Title: Re: FIELD 14 ON CMS1500 FORM NEED HELP
Post by: RichardP on January 28, 2014, 07:11:01 PM
We are in California.  Our billing software has templates for the CMS 1500.  That is, the template has all of the boxes and fields on it that the CMS 1500 has.  We drag and drop individual "data snatchers" into each field we want printed on the CMS 1500 form.  The "data snatchers" correspond to fields in the database.  When properly configured, the template pulls all of the correct data from the database for the target patient and the CMS 1500 form is printed properly.

We have used this billing software since the late 1990's.  There has never been a "data snatcher" placed into Box 14 on our templates.  Since no information has ever been pulled into Box 14 on the template, no information has ever printed on the CMS 1500 form.  And we bill for Ob/Gyn as well as Worker's Comp across multiple specialties.  Never a peep from anybody about data missing in Box 14.