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Oncology & Hematology Coding Alert

NPI Update:

Smooth Your Transition To Revised CMS-1500

Published on Sat Sep 09, 2006

Ring out the old and ring in the new. CMS-1500, that is. CMS is paving the way for you to use National Provider Identifiers with a new claim form, effective Jan. 1, 2007.

The major difference between old (CMS-1500 [12-90]) and new (CMS-1500 [08-05]) is split provider identifier fields on the new form, which allow you to report an NPI (in the field labeled NPI) and the legacy number (in the unlabeled block above each NPI field).

CMS mandates use of the new CMS-1500 form on April 2, 2007--that includes rebilling claims filed with the old form.

Remember: NPI use is required May 23, 2007. At that time, expect a rejection if you don't supply the NPI in all required fields on the new form:

- 24J, replacing item 24K, CMS-1500 (12-90)
- 17B, replacing item 17 or 17A, CMS-1500 (12-90)
- 32a, replacing item 32, CMS-1500 (12-90)
- 33a, replacing item 33, CMS-1500 (12-90). Find out more in the MLN Matters article (MM5060) -Additional Requirements Necessary to Implement the Revised Health Insurance Claim Form CMS-1500,- on the Web at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5060.pdf.
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