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coder1

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Good Afternoon Coding World,


I just read AAPC article regarding version 5010. In this article, it states that PO Boxes can't be used by billing provider. My company would like for me to research this information on CMS website. As I research, I only find a checklist of question to ask vendors in their transition. Could anyone direct me to CMS website for this information.


Thanks
 
5010

I don't know which MAC carrier you are subscribed to, but I checked Cahaba for my area, and went to search entire site, "provider address 5010" and it showed me that a PO Box is not acceptable on the 5010, it must be a street address.

Hope you are able to search your MAC for this information. :)
 
that's correct...no p. o. boxes

I have a relative who works for a clearing house and they have about completed the conversion and training of 5010. That's what he said, no p. o. boxes as billing addresses. Also, you must use the nine digit zip code...not just the five digit one that we are so used to.
 
You cannot use P.O. Boxes on the "Billing Provider address" but you can still use them as a "Payto Address". There are fields in the 5010 to allow for BOTH addresses. The software/EDI vendor must map these in the correct fields in 5010 in order for them not to reject.

http://www.cms.gov/Versions5010andD0/downloads/033011_National_Call_Resource_Mailbox_Qs_and_As.pdf

Q: I understand the billing address can't be a P.O. Box or Lockbox number. Please confirm if the Pay To/Remit address can continue to be a P.O. or Lockbox number and does that address have to match the NPI registry?
A: The pay-to-address can be a P.O. Box. At this time, the EDI front end will not be running a match of the submitted address to the NPI registry.

Q: We know that the 2010AA Billing Provider address must be a physical address and not a P.O. Box. When the electronic claims come in the front door of the A/B MACs, will the A/B MACs validate the address with what is on file at Medicare customer service/provider relations? For example, if a provider sends “123 Any Street” on their claim but they are actually enrolled with Medicare as “123 Any Place Avenue”, must there be an exact match on the address before the claims will pass EDI's edit? Or is EDI not going to be that specific and will just looking to see if the address contains P.O. Box, if so then reject?
A: At this time, the front end system will only be looking for the presence of "P.O. Box" or "Lock Box" in its many different forms. Claims that contain "Post Office Box", "P.O. Box", "P.O. Box", "P.O. Box", "Lock Box", "Lock Bin" as the address in 2010AA will be rejected.
 
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