ACloserLook Reimbursement Issues in Diagnostic Imaging

National Provider Identifier Standard (NPI)

Effective March 1, 2008, providers must list their NPIs on Medicare fee-for service claims 837P and CMS-1500. Claims with both an NPI and a Medicare legacy number will continue to be rejected if the pair is not found on the Medicare NPI Crosswalk. Claims without an NPI in the primary provider field (i.e., the billing, pay-to and rendering fields) will be rejected. Claims that contain only a Medicare legacy number in the primary provider field will be rejected.

Hospitals were required to include their NPIs in the primary provider fields on 837I electronic claims and UB-04 paper claims effective January 1, 2008.

The use of legacy numbers ends May 23, 2008.

For further details, visit http://www.cms.hhs.gov/NationalProvIdentStand/

Winter 2008 Newsletter


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