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HEALTHCARE 123 QUALIFIER CODES FOR THE CMS-1500 CLAIM FORM
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Box 11b - Other Claim ID The following qualifier and accompanying identifier has been designated for use: Y 4 Property Casualty Claim Number Box 14 - Date of Current Illness, Injury, or Pregnancy (LMP) Enter the applicable qualifier to identify which date is being reported. 43 1 Onset of Current Symptoms or Illness 48 4 Last Menstrual Period Box 15 - Other Date Enter the applicable qualifier to identify which date is being reported. 45 4 Initial Treatment 30 4 Latest Visit or Consultation 45 3 Acute Manifestation of a Chronic Conditio
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