As of May 23, Medicare will reject claims with legacy numbers notated anywhere on the claim, even if the National Provider Identifier (NPI) is included in the primary position. This follows the Centers for Medicare and Medicaid Services (CMS) mandate that called for physicians to include their NPIs on claims submitted beginning March 1. Physicians have submitted claims containing both the NPI and the legacy numbers to test the process, as encouraged by CMS in February (for more information, see the February 6 issue of Endocrine Insider: http://www.endo-society.org/publicpolicy/insider/Endocrine-Insider-02-06-08.cfm).

The NPI database will serve as the source for locating physician NPIs. As necessary, physicians will require the NPI of a referring or ordering physician for each separate claim submitted. Claims with legacy numbers apparent will face automatic rejection and will not be eligible for appeal; resubmission with NPI and removal of legacy numbers will be permitted. As previously stated by CMS, in the rare circumstance that a doctor cannot locate the referring physician's NPI in the database and efforts have been exhausted to acquire such information, the doctor should use his own name and NPI to submit the claim.

For more information on NPI implementation and to access the database, visit http://www.cms.hhs.gov/NationalProvIdentstand/