OASIS Alert

Reader Question:

PREPARE TO KEEP UP WITH TWO PROVIDER NUMBERS

Deadline is near, but instructions are missing.

Question: Now that my agency has its National Provider Identifier number, we're not quite sure where it fits in with the numbers we put on the OASIS assessment, on the data we transmit and on the claims we submit. Does the NPI substitute for our Medicare Provider Number in M010? And does the physician's NPI go in M0072?

Answer: There will be no changes to the OASIS assessment form's space for your six digit provider number when the May 23 NPI date arrives, says billing expert Melinda Gaboury with Nashville, TN-based Healthcare Provider Solutions. So you will continue to put your agency's Medicare provider number in M0010 and the physician's UPIN in M0072, she says.

Caution: According to the Centers for Medicare & Medicaid Services' March 2 letter (S&C-07-16) to state surveyors, on May 23 the NPI becomes the only acceptable provider identifier for HIPPA-related transactions, but the government will continue to use the Medi-care/Medicaid Provider Number to certify providers and to verify Medicare certification "on all survey and certification and resident/patient assessment transactions." But this provider number has now been renamed the CMS Certification Number (CCN). "When the NPI is called for on any form or transaction, it should be provided, if available," CMS says. "When the Medicare/Medicaid Provider Number ... is requested, the CCN should be provided," CMS adds. And some activities will require both numbers.

Snag: At press time, CMS still had not released the long-promised Data Dissemination Notice about using NPIs, and no one from CMS was available at the March 14 Home Health Open Door Forum to answer the NPI-related questions from many of the 466 listeners.

Note: More NPI information is at
www.cms.hhs.gov/NationalProvidentStand. The surveyor letter is at www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter07-16.pdf.

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