[Federal Register Volume 61, Number 207 (Thursday, October 24, 1996)]
[Notices]
[Page 55155]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-27292]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-1500]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, is 
publishing the following summaries of proposed collections for public 
comment. Interested persons are invited to send comments regarding this 
burden estimate or any other aspect of this collection of information, 
including any of the following subjects: (1) The necessity and utility 
of the proposed information collection for the proper performance of 
the agency's functions; (2) the accuracy of the estimated burden; (3) 
ways to enhance the quality, utility, and clarity of the information to 
be collected; and (4) the use of automated collection techniques or 
other forms of information technology to minimize the information 
collection burden.
    1. Type of Information Collection Request: Reinstatement, with 
change, of previously approved collection for which approval has 
expired; Title of Information Collection: Medicare/Medicaid Health 
Insurance Common Claim Form and Instructions, and Supporting 
Regulations 42 CFR 424.32 (Basic Requirements for all Claims) and 42 
CFR 414.40 (Coding and Ancillary Policies); Form No.: HCFA-1500; Use: 
This form and instructions are standardized for use in the Medicare/
Medicaid programs to apply for reimbursement for covered services. HCFA 
does not require exclusive use of this form for Medicaid. 42 CFR 424.32 
and 42 CFR 414.40 are regulations underlying the use of the form HCFA-
1500 and the information captured on the form HCFA-1500, including the 
use of diagnostic and procedural coding systems. HCFA solicits comments 
on any and all aspects of the HCFA-1500, and the use of diagnostic and 
procedural coding systems: HCFA currently uses the most current version 
of the ICD-9-CM and CPT/HCPCS; Frequency: On occasion; Affected Public: 
Business or other for profit, not for profit institutions, State, local 
or tribal government; Number of Respondents: 976,239; Total Annual 
Responses: 644,802,413; Total Annual Hours: 46,797,008.
    To obtain copies of the supporting statement and any related forms 
and instructions for the proposed paperwork collection referenced 
above, E-mail your request, including your address and phone number, to 
JB[email protected], or call the Reports Clearance Office on (410) 786-
1325. Written comments and recommendations for the proposed information 
collections must be mailed within 60 days of this notice directly to 
the HCFA Paperwork Clearance Officer designated at the following 
address: HCFA, Office of Financial and Human Resources, Management 
Analysis and Planning Staff, Attention: John Burke, Room C2-26-17, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: October 15, 1996.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 96-27292 Filed 10-23-96; 8:45 am]
BILLING CODE 4120-03-P