Ask the Expert: Do I enter a qualifier in box 14 of the claim form if the patient has Medicare prime and a secondary insurance? November 14, 2014 Medicare Medicare, Billing/Coding 0 Recently a number of practices have inquired as to whether Medicare requires the three-digit qualifier to be populated in item/box 14 when submitting a claim. Item/box 14, Date of Current Illness, Injury, or Pregnancy (LMP), identifies the first date of onset of illness, the actual date of injury, or the last menstrual period (LMP) for pregnancy, and contains a field allowing one of two qualifiers to be entered. 431: Onset of Current Symptoms or Illness 484: Last Menstrual Period The Medicare Claims Processing Manual advises that although space is included for a qualifier, Medicare does not use this information. However, many other payors do require the qualifier. So, in instances where Medicare is prime but the patient has a secondary insurance that requires population of the field, practices will need to include the information. Medicare has advised that while it does not require qualifier information, if needed for a secondary payor, Medicare will ignore the qualifier and the claims will be forwarded to the secondary payor through the coordination of benefits contractor for payment. Comments are closed.
