NPI Stage 2 Implementation Update

BCS staff attended a phone conf on NPI implementation last week. One interesting point that came forth was the possibility of the May 2007 deadline to start using only NPIs may be extended. From the text below it sounds as if that may in fact be in the works....note the text "From the beginning of Medicare’s Stage 2 NPI transition period on October 1, 2006 and until further notice, ...." In the past this "until further notice" portion was not included and was replaced with May 27, 2007 as the actual deadline to use only the NPI. If you read the PDF you will find both this text and reference to the May 27, 2007 deadline.... please review below and retain for future reference.

III. CLAIMS SUBMITTED WITH ONLY A NATIONAL PROVIDER IDENTIFIER (NPI) DURING THE STAGE 2 NPI TRANSITION PERIOD (CMS MLN Matters)

Provider Action Needed
STOP - Impact to You
Beginning October 1, 2006 and until further notice, claims that you submit containing only an NPI will be returned you as unprocessable if a properly matching legacy number cannot be found.

CAUTION - What You Need to Know
From the beginning of Medicare’s Stage 2 NPI transition period on October 1, 2006 and until further notice, you should submit both NPIs and legacy provider numbers on your Medicare claims to ensure that they are properly processed.. During this period, claims submitted with only a NPI that Medicare systems are unable to properly match with a legacy number (e.g., PIN, OSCAR number), may be rejected, and you will be required to resubmit the claim with the appropriate legacy number.

GO - What You Need to Do
You should make sure that when submitting Medicare claims with dates of service on or after October 1, 2006, your billing staff submit both your NPI and legacy provider numbers until further notice from CMS.

To read this article in its entirety please visit the CMS Website at: http://www.cms.hhs.gov/mlnmattersarticles/downloads/mm5378.pdf