Prepare for Upcoming NPI Implementation Deadlines
American Academy of Sleep Medicine
Friday, December 14, 2007
The Centers for Medicare & Medicaid Services (CMS) recently announced two important deadlines regarding NPI implementation:
- March 1, 2008 - This deadline applies to Medicare claims only. Physicians will no longer be permitted to submit paper and electronic claims using just their legacy provider number. All claims must include the physician's NPI, with the option of also including the legacy provider number.
- May 23, 2008 - This deadline applies to all public and commercial claims. Physicians will be required to use only their NPI on all electronic claims. Physicians who bill Medicare on paper must also use only their NNPI starting on this date. No legacy numbers will be permitted on claims after this date.
All sleep medicine specialists are encouraged to take the following steps:
- Look for informational warning about NPI. Since October 15, CMS has been issuing information warnings on pre-pass reject reports (M389, M390, M391, or M392) to billers if no NPI was included on the claim. If you have received one of these messages even though you submitted claims bearing your NPI, it is possible a billing agent or clearinghouse removed the NPI before sending the claim to CMS. Call your clearing house or billing agent to determine how to fix future claims.
- Begin using your NPI immediately. Begin first by sending a few claims through to ensure they process correctly; doing so allows time to correct ant problems CMS may encounter when matching your legacy number to your NPI. Also, make sure your NPI is validated and the correct legacy number appears in the "Other Provider Identification Numbers" field by calling (800) 465-3203. If the information in the NPI system is correct, contact your contractor and ask that they validate their systems.
- If required, reenroll in Medicare immediately. The enrollment process can be lengthy and enough time should be allowed to meet the March 1, 2008, deadline.