Practices Required to Use CMS 1500 Claim Form Effective April 1 March 10, 2014 Medicare, Payment, Practice Management Medicate claims, CMS 1500 0 As of April 1, 2014, CMS will only accept CMS 1500 claim form (version 02/12 OMB control number 0938-1197) for submitting paper claims to Medicare. The revised form adds the following functionality: Indicators for differentiating between ICD-9 and ICD-10 diagnosis codes. Expansion of the number of possible diagnosis codes to 12. Qualifiers to identify the following provider roles (on item 17): Ordering, Referring, Supervising Physicians should note that while the new claim form includes fields for ICD-10 codes in preparation for the transition in October 2014, practices should continue to submit only ICD-9 codes until notified otherwise by payors. Click here for more resources about Form CMS-1500. Comments are closed.