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Provider Notices

Professional claim 1500 Form - Box 14 – Date of Current Illness, Injury, or Pregnancy (LMP) Billing Guidance

7/21/2021 4:13:39 PM

This box is used to report the onset of acute symptoms for a current illness or condition or that the services are related to the patient’s pregnancy.  There are two valid qualifiers for this box, these qualifiers and their guidelines are listed below.

  • 431 (Onset of Current Symptoms or Illness) – This information is required for the initial medical service or visit performed in response to a medical emergency when the date is available and is different than the date of service.  The date entered in this box should not be the same as the date of service, if the dates entered are the same, the claim will be denied.

  • 484 (Last Menstrual Period) – This information is required when, in the judgement of the provider, the services on the claim are related to the patient’s pregnancy.

Effective 8/22/2021- claims billed outside of these guidelines will be denied.