As of April 1, 2014, what is the maximum number of diagnoses that can be reported on the CMS-1500 claim form before a further claim is required?

As of April 1, 2014, what is the maximum number of diagnoses that can be reported on the CMS-1500 claim form before a further claim is required?

• A. 12
• B. 8
• C. 10
• D. 15

Answer: (A)

The form CMS-1500 limits how many diagnosis codes you can put on a single claim. It provides space for twelve ICD-9-CM diagnosis codes, linked by diagnosis pointers to the services billed. So, as of April 1, 2014, you can report up to twelve diagnoses on one CMS-1500 claim before you would need to submit an attachment or a separate claim for additional diagnoses. In practice, you’d list the principal diagnosis first and then the most clinically relevant additional diagnoses up to twelve total; any more codes require a continuation sheet or an electronic claim with extra fields.

The form CMS-1500 limits how many diagnosis codes you can put on a single claim. It provides space for twelve ICD-9-CM diagnosis codes, linked by diagnosis pointers to the services billed. So, as of April 1, 2014, you can report up to twelve diagnoses on one CMS-1500 claim before you would need to submit an attachment or a separate claim for additional diagnoses. In practice, you’d list the principal diagnosis first and then the most clinically relevant additional diagnoses up to twelve total; any more codes require a continuation sheet or an electronic claim with extra fields.