The CMS-1500 (HCFA) Form is used by healthcare providers and professionals to file original workers' compensation medical bills in New Jersey.
Article Contents |
Navigation Link |
Filling out the Form |
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Required Reports |
CMS-1500 Form Instructions
The state of New Jersey has no specific requirements for any billing forms. It is recommended that providers compliantly complete the CMS-1500 Form.
To make things easier for you, daisyBill created this NUCC CMS-1500 Instructions Table showing the requirements of the National Uniform Claim Committee (NUCC), the entity which created and maintains the form. This information is provided for educational purposes only and is not intended to represent state-specific requirements.
For additional information, review the complete NUCC Manual:
1500 Health Insurance Claim Form Reference Instruction Manual for Form Version 02/12
CMS-1500 Billing Documentation
For a complete bill, the provider should consider submitting the following supporting documentation with the CMS-1500 Form when applicable.
CMS-1500 Medical Bill |
Recommended Documents |
Treatment |
Recommend attaching chart notes. |
Surgery |
Operative Report |
Radiology |
Radiology Report if billing for Professional Component |
Laboratory |
Test Results Report |
Diagnostic Testing |
Test Results Report |
For additional information related to reporting please refer to daisyBill’s New Jersey Billing Guide.
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