CMS issues NPI/NPPES Communication
HIPAA Weekly Advisor, March 17, 2008
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CMS released a Communication on March 6 addressing several issues related to NPI implementation and the National Plan and Provider Enumeration System (NPPES).
In the Communication, CMS requests that organization healthcare providers verify their legal business name (LBN) and/or employer identification number (EIN) within the NPPES. CMS is finding that many provider EINs and LBNs do not match the Internal Revenue Service (IRS) data. This is the first step to improving the quality of information in the system, according to the Communication.
CMS also issued a reminder that as of March 1, 837P and CMS-1500 claims must include an NPI in the primary provider fields, though the claims may still include a Medicare legacy number in the field. CMS also issues a list of steps to take if your claims reject.
According to the Communication, CMS is cognizant that some clearinghouses still strip information, including NPIs, from claims. If you experience this, notify your Medicare Contractor so that CMS can resolve the issue with the clearinghouse.
Finally, CMS encourages providers to test their ability to submit claims with only the NPI at this time.
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