Part B Insider (Multispecialty) Coding Alert
NPI-Only Date Is Here-Get Your Claims on Track
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Plus: New DME competitive bidding program awardees announced for 10 communities, effective July 1 In other news ... - If you-re one of the lucky participating states, you can check out how your claims data compares to your peers in the same specialty and geographic location. - Medicare has awarded 325 competitive bidding program contracts for durable medical equipment.
Get ready for denials if you-re not geared up for the National Provider Identifier (NPI) 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,- CMS 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 said.
And you won't be off the hook for leaving referring physicians- NPIs off the claim. If the physician -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. Use the NPI registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do or contact the physician directly for the NPI number in question.
To use your own NPI in the secondary field, you must have -ex-hausted all possibilities of finding the NPI- of the referring or prescribing physician, CMS directs.
Empire Blue Cross/Blue Shield, a Part B carrier in New York and New Jersey, is offering practices a comparative distribution report (CDR) to benchmark their E/M use with other physicians-.
If you-re in one of these two states, you can email your CDR request to eastclinicaleducation@wellpoint.com, along with your PIN, your practice address and phone, and the code family you-re requesting.
In its May 19 announcement, CMS seemed to indicate that the program, which goes into effect on July 1 in 10 communities, will not drive small suppliers out of business, as previously speculated.
-Bids were evaluated to ensure there would be a sufficient number of suppliers, including small suppliers, to meet the needs of beneficiaries living in the competitive bidding areas,- the release noted.
For more on the program, go online to the Web site www.cms.hhs.gov/DMEPOSCompetitiveBid.
Part B Insider (Multispecialty) Coding Alert
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