DOCUMENTATION:
Missing Info Will Generate New Remark Code Alert
Published on Tue Jun 23, 2009
Check that your claims include the required ordering physician ID number. Starting Oct. 5, intermediaries and carriers will begin Phase 1 of the physician ID edit -- which means you'd better double check details. They will still process a claim when an ordering doc's National Provider Identifier (NPI) number isn't in the PECOS or contractor file, the Centers for Medicare & Medicaid Services explains in Transmittal No. 510 (CR 6417), reissued June 26. But the claim will carry a new remark code: "M68 (missing/incomplete/invalid attending, ordering, rendering, supervising or referring physician identification)." When CMS begins Phase 2 of the project, which doesn't yet have a start date, that claim without a valid physician NPI will get rejected, CMS notes in a related MLN Matters article at
www.cms.hhs.gov/MLNMatters/Aticles/downloads/MM6417.pdf. The reissued transmittal is at
www.cms.hhs.gov/transmittals/downloads/R510OTN.pdf.