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Home Health & Hospice Week

Industry Notes:

Physician Number Edits To Slam DME Claims In New Year

Published on Tue Oct 20, 2009

Are the NPIs on your claims valid? Suppliers may start the new year off with severely restricted cash flow if they don't pay attention to a new claims edit taking effect in January. "Contractors are now comparing the [National Provider Identifier numbers] of ordering physicians listed on DME claims against a national list of Medicare-approved physician NPIs in the Medicare Provider Enrollment Chain and Ownership System (PECOS) database," warns the American Association for Homecare. Back in April, the Centers for Medicare & Medicaid Services announced its new edits on ordering physician NPIs (see Eli's HCW, Vol. XVIII, No. 20, p. 159). Currently, contractors are just giving suppliers warnings about the invalid NPIs. But in January, Medicare will start denying payment for those claims. Up to 60 percent of DME claims are currently receiving warnings, AAHomecare says. "These warnings will turn to rejections beginning January 4," the trade group cautions. Resource: [...]
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