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NATIONAL PROVIDER IDENTIFIER (NPI)
DEADLINE PUSHED BACK

The CMS has extended the deadline by one year for requiring all claims to be accompanied by an NPI. The decision was made because many covered entities would not be able to fully comply with the NPI standard by May 23, 2007.

As a resource for WMPN physicians, WMPN is collecting the new physician National Provider Identifier (NPI). If you have not already submitted your NPI number to WMPN, please do so by e-mailing NPI numbers to vicki.woodard@spectrum-health.org.


NPI KEY DATES:

March 1, 2008 Implementation Steps:

·         Medicare FFS 837P and CMS-1500 must include an NPI in the primary fields on the claim (i.e., the billing, pay-to, and rendering fields).

·         You may continue to submit NPI/legacy pairs in these fields or submit only your NPI on the claim. You may not submit claims containing only a legacy identifier in the primary fields.

·         Failure to submit an NPI in the primary fields will result in your claim being rejected or returned as "unable to process."

·         Until further notice, you may continue to include legacy identifiers only for the provider secondary fields.

May 23, 2008 Implementation Steps:

·         In keeping with the Contingency Guidance issued on April 3, 2007, CMS will lift its NPI contingency plan, meaning that, for all primary and secondary provider fields, only the NPI will be accepted and sent on all HIPAA electronic (837I, 837P, NCPDP, DDE, 276,277, 270/271, and 835), paper claims (UB-04 and CMS-1500) and SPR remittance advice.

·         The reporting of legacy identifiers will result in the rejection of the transaction.

·         CMS will also stop sending legacy identifiers on COB crossover claims at this time.

More information on NPI can be found through the CMS NPI page on the CMS website at www.cms.hhs.gov/NationalProvIdentStand

Providers can apply for an NPI online at www.nppes.cms.hhs.gov or by calling the NPI enumerator to request a paper application at 800-465-3203.