21 (A-L) Diagnosis or Nature of Illness or Injury At least one Required Enter the appropriate ICD-9-CM/ICD-10-CM codes (up to 12). Enter the primary diagnosis in 21(A). If applicable, B, C, and other diagnosis in 21 (A-L). Always enter the entire diagnosis code including the decimal point. Enter a 9 for ICD-9-CM or a zero for ICD-10-CM codes in the ICD Ind. field. Note: External Cause of Injury/Morbidity codes are not billable as the primary diagnosis on CMS 1500 claims.
24E (unshaded) Diagnosis Pointer Required if diagnosis code in block 21 is present Use A-L for the corresponding diagnosis code entered in field 21.
24H (unshaded) EPSDT Family Plan Required if applicable Not required unless applicable. If the services performed constitute an EPSDT program screen, refer to the instructions for EPSDT claims in the provider handbook.