Fill out professional and institutional claims correctly — patient, insured, provider, diagnosis pointers, service lines, revenue codes, type of bill and value/occurrence codes.
The CMS-1500 at a glance
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The professional claim (paper CMS-1500 / electronic 837P) has 33 numbered items in two parts:
• Top (items 1–13): patient and insured — payer type, insured's ID, names, addresses, DOB, sex, relationship to insured, other insurance (for COB), whether the condition is related to employment/auto/other accident, signatures on file.
• Bottom (items 14–33): provider and services — dates, referring provider, prior authorization, diagnosis codes, service lines, charges, NPIs, tax ID, service facility and billing provider.