Field 14 - Date of Current Illness, Injury, or Pregnancy (LMP)
The “Date of Current Illness, Injury, or Pregnancy” identifies the first date of onset of illness, the actual date of injury, or the LMP for pregnancy.
NUCC INSTRUCTIONS: Enter the 6-digit (MM│DD│YY) or 8-digit (MM│DD│YYYY) date of the first date of the present illness, injury, or pregnancy. For pregnancy, use the date of the last menstrual period (LMP) as the first date.
Enter the applicable qualifier to identify which date is being reported.
431 Onset of Current Symptoms or Illness
484 Last Menstrual Period
Enter the qualifier to the right of the vertical, dotted line.
MEDICARE INSTRUCTIONS - Enter either an 8-digit (MM | DD | CCYY) or 6-digit (MM | DD | YY) date of current illness, injury, or pregnancy. For chiropractic services, enter an 8-digit (MM | DD | CCYY) or 6-digit (MM | DD | YY) date of the initiation of the course of treatment and enter an 8-digit (MM | DD | CCYY) or 6-digit (MM | DD | YY) date in item 19.
Additional information for form version 02/12: Although this version of the form includes space for a qualifier, Medicare does not use this information; do not enter a qualifier in item 14.
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