Free Billing Tool
CMS-1500 Claim Checker
Run a structured pre-submission review for common CMS-1500 problems: required information, NPI check digits, diagnosis pointers, service-line dates, procedure formats, units and total charges.
Claim information
Enter the fields you want to check. Use the sample button to see a complete example.
Diagnosis codes (Box 21)
Enter up to 12 diagnosis codes. Service-line diagnosis pointers use letters A through L.
Service lines (Box 24)
Up to 6 service lines. A rendering NPI is checked when entered; whether Box 24J is required depends on the claim.
Claim readiness check
What the CMS-1500 checker reviews
The tool looks for missing patient and billing-provider information, validates 10-digit NPIs using the CMS check-digit method, checks service-line date and code formats, confirms diagnosis pointers reference entered diagnoses, verifies units and charges, and compares Box 28 total charges to the sum of the service lines.
What it does not decide
A clean-looking claim can still be rejected or denied because of eligibility, medical necessity, authorization, coding edits, payer-specific rules, coverage policy, enrollment or other requirements. Treat this as a pre-submission quality check rather than a guarantee of payment.
Need to prepare CMS-1500 claims?
Use the checker for a quick review, then prepare, save, retrieve and print claims with CMS-1500 + UB-04 Software for Windows.
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