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Medicare Billing: CMS-1450 & 837I

Lesson 4 Summary

  • CMS-1450 FLs identify the data elements required for the CMS-1450 and the 837I electronic loops
  • Data elements in the CMS-1450 data set are consistent with the uniform 837I electronic billing specifications
  • Some FLs are required by Medicare, while others are situational or not required
  • The NUBC publishes codes in their Official Uniform Billing (UB)-04 Data Specifications Manual, available by subscription
  • Providers use a standardized coding system called Level II of the HCPCS mainly to identify products, supplies, and services not included in the CPT-4 codes
  • You can find Medicare CMS-1450 completion and coding instructions in Chapter 25 of the Medicare Claims Processing Manual