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New Required Fields on CMS 1500 Claims

Date: 03/04/19

Ambetter has changed its policy as it relates to required fields on the CMS-1500 claim form. Formerly box 18 was listed as a conditional/optional field. If you are submitting an inpatient professional service/s, with a location (box 24B) value of 06, 08, 21, 31, 32, 51, 54, 55, 56, or 61, Ambetter is now requiring box 18 (“Hospitalization Dates Related to Current Services”) to have the date of admission populated in the ‘FROM’ portion of this field.

To see the full announcement, click here (PDF)