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CMS 1500 Claim Forms ICD-10 HCFA (Version 02/12) - Health Insurance, Laser Cut Sheet - 1000 Sheets
Look on our Amazon Store (TWIhealthcare) for ICD-10 envelopes and other products. Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant. This form was revised to align the paper form with some of the changes in the electronic health care claims Professional (837), Technical Report Type 3 (5010) and Technical Report Type 3 The most significant change was the addition of 8 diagnosis codes in field 21. Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems. Printed with OCR dropout red ink on 20lb. paper (per government

Price is $38.00

Price: $37.86