Box 21. - DIAGNOSIS OR NATURE OF ILNESS OR INJURY Relate A-L to service line below (24E)

Enter the applicable ICD indicator to identify which version of ICD codes is being reported between the vertical, dotted lines. (ICD Ind. determined by a check box on the diag. code) 9 | ICD-9-CM
0 | ICD-10-CM Enter the patient’s diagnosis and/or condition codes. List no more than 12 ICD-9-CM or ICD-10-CM diagnosis codes. Relate lines A - L to the lines of service in 24E by the letter of the line. Use the highest level of specificity. Do not provide narrative description in this field.

(12 diagnosis codes at a maximum of 7 characters in length.)

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Note - In the 'ICD Ind.' box, the 9 or the 0 are automatically entered when you choose the ICD code. On paper OR PrtCap, as long as just one ICD code is an ICD10 code, the 'ICD Ind.' box will have a 0 in it. (In ANSI each code is checked and a BK or BF qualifier is for an ICD9. An ABK or ABF qualifier is for ICD 10).

Note - If you are using the Plus/Advanced version of eclipse, you can enter up to 4 ICD codes on each service at time of charge entry and do not need any entered on the condition screen. (Same as 'Pointing' services to diagnostic codes).

Note - If you have diagnosis descriptions or sublexation levels showing up in this box, upgrade to 2/27/14 or above (see note on box 19)(make sure you are using the 2/12 form if doing PrtCap).

Note - ver 10/18/15 to ver 10/23/15 the ICD ind box was always = 0 even for ICD9 codes.

Note - ver 10/19/15 and above: Two new payer specific overrides allow you to either display ICD-10 decimal points in CMS-1500 box 21 or squeeze the characters together to eliminate the space that represented the decimal point. These can be adjusted on any payer’s Printed Claim Options tab and affect both printed & “print capture” versions of the 2/12 form.