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Hello!
When seeing patients for dental care after an accident I have always used box 14 on to list the accident date, whether it was the date for actual services or not. I never used a qualifier. I have never used box 15.
In this particular instance, patient had accident on 8/11/2021 (date in box 14) and seen us the next day 8/12/2021 which is listed box 24A.
BCBS returned claim w/ the following information:
Box 15 requires a qualifier of 439 and date when account is indicated
Box 14 contains date/qualifier is blank/invalid or illegible
I'd think Box 14 remains the same of accident date w/ qualifier 431 (onset of current symptoms/illness/injury occurred) and box 15 would list 8/12/2021 then w/ qualifier 454 - initial treatment... but this is still wrong w/ them requiring qualifier 439 as stated above for box 15.
Can you help straighten me out?
I've never been asked for this info before.
Thanks so much!
Jill T.
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Jill T! Here is a link to the NUCC's CMS1500 claim form instructions: https://nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2021_07-v9.pdfPage 23 supplies the details for field 14, and the details for field 15 are found on page 24. Based on these instructions, it looks like it may be: Field 14: qualifier 431 with date of accident/injury (8/11/2021) Field 15: qualifier 439 with date of accident (8/11/2021) Also be sure to complete field 10 for the accident as well! Hope this helps!
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