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Oncology & Hematology Coding Alert

Reader Questions:

Aim to Use NPI ASAP

Published on Thu Jun 28, 2007

Question: I-m confused about the NPI deadlines. Is there a decision about when we must use NPIs yet?

Utah Subscriber  Answer: If your providers have NPIs and you have the NPIs of referring providers, you should be reporting them on your electronic claims.

In May, CMS will assess how many providers are submitting claims with NPIs. If the ratio is high enough, it will start requiring NPIs from all primary providers in July, says MLN Matters article MM5595. If the ratio isn't yet high enough, the agency will reassess in June for an August implementation.
 
-As soon as the number of claims submitted with an NPI for primary providers - is determined sufficient - Medicare will begin rejecting claims that do not contain an NPI for primary providers,- CMS says.
 
Primary providers for NPI purposes are -billing, pay-to and rendering providers,- CMS says.
 
You don't have to furnish referring physicians- NPIs on claims until May 2008. Providers can include -secondary- providers- legacy numbers, including UPINs, on Medicare claims until that date.
 
Resource: The MLN Matters article is at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5595.pdf.
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