CMS 1500 claim form billing instruction Part 6

BLOCK 23 PRIOR AUTHORIZATION NUMBER

CMS 1500 claim form billing instruction Part 5

CMS 1500 claim form billing instruction Part 4

CMS 1500 claim form billing instruction Part 2

CMS 1500 claim form billing instruction Part 3

CMS 1500 claim form billing instruction Part 1

Enter the Professional Review Organization (PRO) prior authorization number for those procedures requiring PRO prior approval.
Enter the Investigational Device Exemption (IDE) number for those clinical trial procedures requiring IDE approval.
For paper claims only, enter the ten - digit Clinical Laboratory Improvement Act (CLIA) certification number for laboratory services. Only one CLIA number may be reported per claim.
Completion of this field is conditional the situations above

CMS 1500 - BLOCK 24A DATES OF SERVICE