Filling Out Work Comp Bills

DaisyBill’s Revenue Cycle Management software walks users through the CMS 1500 or NCPDP form step-by-step to ensure completeness and compliance. Should you need to manually fill out a billing form, the DWC offers free resources.

Frequently Asked Question

Q: Can I handwrite these fields on a paper bill?

A: No. Use a typewriter or printer for original bills, but do not handwrite.


The California’s Division of Workers’ Compensation has directions for filling out all the fields in work comp forms.  Find these directions in the CA DWC Medical Billing and Payment Guide, on the Field Tables in Appendix A to Section One.  There are four sections, each covering one of the standard paper billing forms.


DWC Medical Billing and Payment Guide

Example of the Field Table for CMS 1500:

CMS 1500 Field Table

Note: Appendix A has two different Field Tables for CMS 1500.  Make sure to use Field Table 1.2, which is for bills submitted after April 1, 2014.  

Additional Information

Division of Workers’ Compensation Medical Billing and Payment Guide

DaisyBill Resources

Webinar: Overview of California Workers’ Compensation


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