On the CMS-1500 claim form, Box 16 reports the dates a patient was unable to work in their current occupation. This guide explains what the box means and how Pabau handles it.
NOTE: This article is part of the US Insurance Billing Additional Resources series, which walks through every box of the CMS-1500. If you are new to claims in Pabau, start with Creating a US Professional (CMS 1500) Claim.
Box 16 — Dates patient unable to work
Box 16 carries a FROM and a TO date — the date range during which the patient could not work in their current occupation because of the condition being treated. It matters when an injury caused missed work, which in practice means employment-related (workers' comp) claims; for everything else the box is left empty.
How Pabau fills it
Pabau leaves Box 16 blank — the claim editor has no work-absence date fields, so nothing is printed in the box or sent electronically for it. That holds even when Employment related is set to Yes in the Claim details section (the Box 10 question). Most professional claims are processed without these dates, so for the typical claim there is nothing to add.
NOTE: If a workers' comp payer requires the work-absence dates, add them in the Claim.MD portal after sending the claim (open the claim under Manage Claim and edit it there), or hand-fill the box on the printed form.
For printing and hand-finishing paper claims, see Exporting and Submitting CMS1500 Claims Manually.