CMS 1500 claim form "ICD-10" HCFA (version 02/12) - health insurance, laser slicing - 2500 sheets

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approved by the National Unified Claims Commission (NUCC); complies with HIPAA. This form has been revised to align paper forms with some changes in eHealth claims: Professional (837), 00005X222 Technical Report Type 3 (5010) and 0000510X222A1 Technical Report Type 3 (5010A1). The most important change is the addition of 8 diagnostic codes in field 21. Include a new QR code identifier at the top of the form to support and align with the industry scanning system. Printed in 20-pound OCR "dropout" red ink. Paper (according to government regulations). Forms are not available for personalization. Certification chain of custody; promote sustainable forest management. Size: 8-1 / 2x11 ", doctors can pass the CMS 1500 Compliance with Medicare and Medicaid Service Center Guide
cms 1500 (02/12) Declaration Form can be used for ICD-10 code
2,500 sheets



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