Endocrine Insider
February 6, 2008

Beginning March 1, Medicare will require full usage of the National Provider Identifier (NPI) for claims processing. After this date, physicians who provide only legacy numbers as a physician identifier on Medicare claims will be denied payment. Currently, claims that use legacy numbers are being paid. Claims with both an NPI and Medicare legacy number will also continue to be paid after March 1 if the pair is found on the Medicare NPI Crosswalk.

According to the Centers for Medicare and Medicaid Services (CMS), it is important that providers begin testing their claims procedures to determine whether the process is functioning if they provide only NPIs. Testing can be done by submitting a handful of claims with only the NPI number in the primary provider field. If reimbursement is received, then providers should continue to increase the number of claims submitted using the NPI. If claims are denied, providers need to contact their Medicare carrier for advice and assistance. This preparation will help to ensure that claims are not denied after the March 1 implementation date.

Endocrine Society staff will report on any additional changes related to NPI implementation in future issues of Endocrine Insider.