NPIs & Medicare Claims: Deadline January 1
Effective January 1, 2008: Medicare contractors will reject 837I electronic claims and UB04 paper claims without a National Provider Identifier (NPI) in fields identifying the primary provider (billing and pay-to). Legacy identifiers paired with NPIs in the primary provider fields will still be acceptable, as will legacy-only numbers in secondary provider fields.
Looking further ahead, as of March 1, 2008, Medicare fee-for-service providers using an electronic claim form ASC X12 837P or the paper claim form CMS-1500 must include an NPI in the primary fields (the billing, pay-to, and rendering fields). Providers may continue to submit NPI/legacy pairs in these fields or submit only their NPI. Failure to submit an NPI in the primary fields will result in the claim being rejected or returned as “unprocessable.”
As of May 23, 2008, Medicare will accept only NPIs on all HIPAA electronic transactions, paper claims, and SPR remittance advice. Reporting of legacy identifiers will result in rejection of the transaction.