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Pulmonology Coding Alert

Reader Questions:

NPI Denials May Be From 1 Small Detail

Published on Mon Sep 08, 2008

Question: I applied for my NPI early, put it on my claims by the deadline, and added my legacy number. I did everything by the book, but my claims are pouring in as denials from my carrier. What could I be doing wrong?Maine SubscriberAnswer: The most likely reason that your carrier denied the claims is that you included the legacy number. One Part B Medicare carrier for five states (NHIC), including Maine, listed use of the legacy number as its number-one error since the May 23 NPI deadline took effect.According to a CMS press release, many clearinghouses are stripping legacy numbers off of claims, but not all clearinghouses have done so.-- The answers to the Reader Questions and You Be the Coder were provided and reviewed by Alan L. Plummer, MD, professor of medicine in the division of pulmonary, allergy, and critical care at Emory University School of Medicine in Atlanta; and Carol Pohlig, BSN, RN, CPC, ASC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.
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