Important NPI update for Medicare billing |
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Starting on March 1, all Medicare claims must contain a National Provider Identifier (NPI) and legacy number, or just an NPI number, for billing, pay-to and rendering physicians. Legacy numbers can still be used to identify referring and ordering physicians through the end of the NPI contingency period, which is May 23. Physicians who bill Medicare and are being paid for claims submitted with both an NPI and a legacy number are urged to test their ability to get paid using just their NPI. In order to accomplish this task, physicians should try to submit one or two claims as soon as possible. Going through this process may be important in order to ensure that your claims will be processed without interruption beginning March 1. If Medicare cannot match a physician’s NPI to his or her legacy number in its system, the claim with an NPI only will be rejected. If the claim is processed and the physician is paid, the physician can continue to increase the volume of claims sent with only the NPI. If you claim is rejected you should call PalmettoGBA for advice right away. Also of importance is the fact that if Medicare cannot match a physician’s NPI to his or her legacy number, the physician might be required to re-enroll, a process that can take several months. Act now to avoid claims processing problems on March 1. After May 23, no legacy numbers will be permitted on any electronic claims, including those to Medicare and commercial payers, pursuant to the Health Insurance Portability and Accountability Act. In addition, no legacy numbers will be permitted on Medicare paper claims after this date. For more information about the NPI go to |
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