National Uniform Claim Committee – NUCC

While medical billing and coding professionals may not immediately recognize the National Uniform Claim Committee (NUCC) by name, experienced professionals will undoubtedly be familiar with its signature creation, the 1500 Claim Form. Used by CMS and countless other healthcare providers, the 1500 Claim Form is one of the most popular means of claiming payment for healthcare services. With such an influence over the entire billing and coding profession, those involved in this field may be curious to know more about the NUCC.

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The NUCC is hosted and chaired by the American Medical Association (AMA). It was founded in 1995 as a new incarnation of its predecessor organization, the Uniform Claim Form Task Force, which was incidentally comprised of representatives from the American Medical Association and the predecessor organization of CMS, the Health Care Financing Administration. The 1500 Claim Form was technically developed by the Uniform Claim Task Force.

With its close relationship to Form 1500 and thereby standardized billing, the NUCC currently plays a key role in national data definitions and content standardization. Compared to its predecessor organization with members representing just two organizations, today there are 18 different organizations (see list below) represented in the NUCC, and many of these represented agencies are comprised of members representing still other organizations.

The passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1996 expanded the responsibilities of NUCC from just data standardization. One of the provisions in HIPAA mandated the federal creation of standards that would facilitate easier electronic transactions of healthcare data, which would subsequently result in the creation of Electronic Health Records (EHRs).

When this HIPAA provision was enacted, four organizations were named to be consultants with the federal agency responsible for the creation of these standards, and the NUCC was one of them. HIPPA also established what is known as the Designated Standards Maintenance Organizations (DSMO), naming the NUCC as one of six agencies responsible for maintaining this body.

Over the last decade the NUCC has been steadily shifting from a focus on the standardization of paper claim forms to include the ever-growing preference for electronic claims. Today the primary goal of the NUCC is to advocate and support the healthcare industry’s adoption of uniform data and nationally-standardized transactions. It does this through consultation with its members who represent a wide variety of related healthcare organizations.

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Organizations with Representation in the NUCC

The following organizations send individuals to serve as representing members with the NUCC :

  • Alliance for Managed Care
  • American Academy of Physician Assistants
  • American Association for Home Care
  • American Medical Association
  • American National Standards Institute, Accredited Standards Committee X12 (ANSI ASC X12N)
  • America’s Health Insurance Plans
  • Blue Cross Blue Shield Association
  • Centers for Medicare and Medicaid Studies (CMS)
  • Dental Content Committee
  • Healthcare Information and Management Systems Society (HIMSS)
  • Health Level 7
  • Medical Group Management Association
  • National Association of Medical Directors
  • National Council for Prescription Drug Programs
  • National Uniform Billing Committee
  • Public Health Data Standards Consortium, with state and federal representation
  • State Medical Association
  • Veterans Health Administration