You're responsible for obtaining referring physicians' numbers, feds remind.
Don't be surprised to see claims rejections if you're not geared up for the National Provider Identifier requirements that hit May 23.
"As of May 23, Medicare FFS will require and send NPI-Only in ALL provider identifier fields for all HIPAA and paper transactions where a provider identifier is required," the Centers for Medicare & Medicaid Services warned on the eve of the deadline. "If you send Medicare a transaction with a Medicare legacy identifier in any of the provider fields, your claim will be rejected," CMS told providers.
And providers aren't off the hook for furnishing referring physicians' NPIs just because there's a backup plan. If the doc "does not furnish an NPI, the billing provider must attempt to obtain that NPI in order to enter it on the claim," CMS reminds providers. Providers can use the NPI registry at
https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do or contact the physician directly for the number.
Last resort: To use its own NPI in the secondary field, a provider must have "exhausted all possibilities of finding the NPI" of the referring or prescribing physician, CMS directs.
If all your efforts are for naught, don't leave the secondary field blank, the agency warns. "Medicare will reject claims if Medicare policy requires a secondary identifier and there is no NPI present," it says. It's OK to use your own NPI in the field if you've made a good faith effort to find the doc's NPI first. More information on NPIs is at
www.cms.hhs.gov/NationalProvIdentStand. • Congress' budget resolution for 2009 is looking like it won't contain any Medicare or Medicaid cuts but providers are still vulnerable to rate reductions that will take place in 2008.
House and Senate Democratic leaders have nearly come to an agreement on a 2009 budget blueprint that rejects President Bush's proposed spending reductions for Medicare and Medicaid, according to press reports. The resolution isn't binding and will guide budget negotiations later this session.
But the package that will head off physicians' 10 percent cut to Medicare rates set to take effect July 1 could be much more threatening to home care providers. Lawmakers are still looking for ways to fund the physician fix, and home health agencies, hospices and durable medical equipment suppliers are all on the short-list for rate reductions. • Your patients on oxygen may have an easier time traveling by air, thanks to a new rule from the Department of Transportation. The DOT now requires airlines to allow all passengers needing portable oxygen access to aircraft. "Prior to the new ruling, portable oxygen containers were designated as a permissible carry-on item, but airlines were still permitted to deny passengers carrying these containers," notes a release from [...]
