Health Information Management

CMS moves mandatory NPI use deadline to January 1, 2008

HIPAA Weekly Advisor, October 15, 2007

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CMS has announced that since the majority of providers are already sending claims to Medicare with a NPI, the agency will move the date for mandatory use of NPI in Medicare claims from May 23, 2008 up to January 1, 2008, according to the Web site for Wheatlands Administrative Services, a subsidiary of Blue Cross and Blue Shield of Kansas.

As of January 1, claims must include a NPI or both a NPI and legacy provider identifier in the primary fields, such as billing and pay-to fields, though secondary fields may continue to contain only legacy identifiers. Claims sent without an NPI in the primary fields will be returned as unprocessable.

The change of dates is a due to the fact that the Medicare NPI crosswalk has been operating successfully since June, according to an October 2 article on Wheatlands' Web site.

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