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The NUCC has finally announced the approval of the version 02/12 1500 Health Insurance Claim Form (1500 Claim Form) that supports the reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3.

An announcement will soon be made once the NUCC has finalized its transition timeline. Meanwhile, the CollaborateMD team will begin to work on the programming and implementation needs for the revised 1500 Claim Form.

Feel free to visit our exclusive CollaborateMD training page or visit www.NUCC.org to find the following information related to the revision:

  • 02/12 1500 Claim Form Sample
  • 02/12 1500 Form Change Log
  • v1.1 0613 0212 NUCC 1500 Instruction Manual
  • 02/12 1500 Claim Form Map to X12 837P
  • Frequently Asked Questions
  • 02/12 1500 Claim Form Approval Announcement

To receive copies of the 02/12 1500 Claim Form, you can contact:

  • Your current forms supplier;
  • TFP Data Systems: 1500form@tfpdata.com or 800.482.9367 ext. 58029; or
  • The Government Printing Office: Government Forms Phone Directories or 800.512.1800

Please be aware that TFP and the Government Printing Office will have the print files and specifications available as of June 20th, 2013.

Further notifications will be provided once the NUCC finalizes its transition timeline.


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