NUCC Approval of the 02/12 1500 Claim Form

posted Jun 24, 2013, 8:30 AM by Angelique Belot   [ updated Aug 13, 2013, 12:42 PM ]
Dear Users,

The NUCC has 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 be made once the NUCC has finalized its transition timeline. CollaborateMD will begin to work on the programming and implementation needs for the revised 1500 Claim Form.

Please visit our training website at and click on the 1500 (02/12) tab 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 Question's
  • 02/12 1500 Claim Form Approval Announcement
To receive copies of the 02/12 1500 Claim Form, contact:

  • Your current forms supplier;
  • TFP Data Systems: or 800-482-9367 ext. 58029; or
  • The Government Printing Office: or 800-512-1800
TFP and the Government Printing Office will have the print files and specifications available as of June 20, 2013. Further notification will be provided once the NUCC finalizes its transition timeline.