Gastroenterology Coding Alert

Question: Our MAC just told us that patients will be bringing in new Medicare cards starting this month. What do we need to know to prepare?

Codify Subscriber

Answer: You're correct in noting that CMS said Medicare beneficiaries will start receiving their new and improved cards in April to decrease fraudulent use of Social Security numbers. However, not all patients will get new cards at the same time, so remind patients not to panic if they know people who have received their new cards but they haven't. CMS has said it "will begin mailing new Medicare cards to all people with Medicareon a flow basis by geographic location and other factors."

Between April and June 2018, the cards will be sent out in waves starting with Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia in the first group and ending with Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Puerto Rico, Tennessee, and the Virgin Islands in the seventh and final wave, the distribution report suggests.

You'll want to make sure your billing system is ready to do all the following for the Medicare Beneficiary Identifier (MBI) on day one, according to CMS guidance:

• Recognize and accept the new MBI.
• Revise your practice protocols for Medicare Railroad Retirement Board (RRB) patients because they won't be distinguished by their card numbers anymore.
• Accept automatically the new MBI from the Remittance Advice (835) transaction.

If you haven't already, alert your patients, software vendors, and business partners of the Medicare card overhaul, the agency advises. Patients' addresses must be accurate and verified by the start date to avoid delivery issues and delays. Moreover, it's of utmost importance that management prepare staff for new Medicare patients who will only receive a card with the MBI to avoid claims problems down the line, CMS suggests.

Good news: There will be a transition period when you can use either the current number or the MBI to » » » exchange data and information with us, notes the MBI fact sheet. "The transition period will start April 1, 2018 and run through December 31, 2019." The agency plans on monitoring Medicare provider efforts throughout this timeline, "so that Medicare operations aren't interrupted and that everyone is ready to use only MBIs by January 2020," state CMS Open Door Forum (ODF) materials on the transition.

Each unique MBI will consist of 11 randomly-generated alphanumeric characters that will be "non-intelligent." In other words, they won't have any special or hidden meaning. CMS will use the numbers 0-9 and letters from A to Z in the MBIs, according to a CMS fact sheet. An exception to this rule is that the letters S, L, O, I, B, and Z will not be included.

If you're wondering what an MBI could look like, CMS offers this example for your reference: 1EG4-TE5-MK73. You may notice that although dashes do appear on the new cards, these dashes are not considered part of the MBI and should not be entered into computer systems or used in file formats, according to CMS advice.