Neurology & Pain Management Coding Alert

National Provider Identifiers kick in this spring

The clock is counting down to HIPAA's deadline for obtaining a National Provider Identifier (NPI) for each of your physicians. Read on for tips on how to meet the requirements before time runs out.

Yes, Everyone Needs the NPI

The NPI is a 10-digit identification number that is intelligence-free, meaning that the numbers don't indicate other information about providers (such as specialty or location). HIPAA requires that all carriers (except very small carriers, healthcare clearinghouses, and HIPAA-covered healthcare providers) begin using unique NPI numbers by May 23, 2007.
 
Beginning May 23, you must include an NPI number on all HIPAA standard electronic transactions, claims or benefit-related communications in electronic media, whether you physically transport the information or transmit electronically. Other insurer guidelines or state laws might also require NPI use.

Don't forget tax numbers: Once NPI numbers go into effect, you will continue to use Social Security numbers and taxpayer identification numbers for taxpayer identification purposes.

Follow the Steps With Ease

Before you can comply with this regulation, you must apply for NPI numbers for each of your physicians.

-Applying for the new NPI is extremely easy and costs nothing except about 30 minutes of your time,- says office manager Laura Bassett, RMM, in Columbia, Tenn.

Spend a bit of time organizing your information, and getting squared away with NPIs for your physicians will be a snap.

Choose Between Online and Paper Applications

Start the process by deciding whether you-ll file an NPI application online or if you-ll follow the paper route instead. Either way, you-ll file through the National Plan and Provider Enumeration System (NPPES).

Paper filing: If you decide to fill out and submit a paper application, you must request the form from and return it to the NPI enumerator. Call (800) 465-3203 or e-mail customerservice@npienumerator.com for an application. You can also submit your request in writing to: NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059.

Online option: For a faster response time, file your application online through CMS at nppes.cms.hhs.gov/NPPES/Welcome.do. Follow the instructions, including selecting a user name and password.
 
Pay attention: Write down and keep track of your user name and password, and be sure you don't make any typographical errors. Print a copy of each application page as you fill it out, for future reference.

When you file online, you-ll receive an e-mail confirmation that NPPES received the application.

-I did four applications in about an hour and submitted them, and within 24 to 48 hours I received an e-mail with the NPI numbers that had been assigned. It is that easy,-  Bassett says.

Collect Your Information Beforehand

-Have all the information for the provider available in front of you when you begin the process,- says business office manager Margaret Fisher in Tacoma, Wash. That way you won't have to chase down details in the middle of the application process. Getting organized is especially important for online applications because you can't save your work and go back later to complete details.

What you-ll need: You-ll need quite a bit of information to complete the NPI application, but it should be easily accessible. Collect this information for each physician before getting started:

- Social Security number or IRS tax ID number

- Date of birth

- Country of birth

- State of birth

- Mailing address (wherever your physician prefers to receive business mail, whether it's a home address, P.O. box or office address)

- Practice location address and telephone number

- Taxonomy (provider specialty)

- State license information, if needed

- Contact person's name

- Contact person's phone number and e-mail. 

Tip: Every covered entity needs an NPI number. That means if you-re applying for more than one physician or an incorporated individual, you need to get an NPI for each individual (Type 1 NPI) as well as for the incorporated practice (Type 2 NPI), which requires an employer identification number.

Example: If you code for a neurology practice with four physicians, you-ll need to apply for five NPI numbers: one for each individual, plus one for the group.

Get More Information

If you still have questions about NPIs or the application process, help is available. CMS offers NPI information and the application online at www.cms.hhs.gov/nationalprovidentstand/01_overview.asp?. 

You-ll find helpful training tools under -Educational Resources,- including the NPI Viewlet, an excellent tutorial on the NPI and application process at www.cms.hhs.gov/apps/npi/npiviewlet/asp.