Ophthalmology and Optometry Coding Alert

Question: How long do we have before we need to start reporting Medicare claims with the patient’s MBIs? We’re still using their old ID numbers but we’d like to know when we have to switch over.

Codify Subscriber

Answer: If patients give you their new Medicare news and their updated identifiers, then your best bet is to begin using them now.

CMS announced that it “sent new cards to more than 61 million people with Medicare across all U.S. states and territories, completing the mailing ahead of schedule,” according to a new release. The original deadline for sending the new cards was April 2019, after starting in April 2018.

Technically, providers do have until Dec. 31, 2019to switch over to using the new MBIs instead of the old Social Security Number-based Health Insurance Card Numbers, CMS allows. But “safeguarding our beneficiaries’ personal information continues to be one of our top priorities,” CMS Administrator Seema Verma says in the release. The Trump Administration expedited the issuance of the new MBI cards “to ensure the protection of Medicare beneficiaries and taxpayer dollars from the potential for fraud and abuse due to personal information that existed on the old cards.”

Verma adds, “These new cards will not only be easier for beneficiaries, but also provide the Medicare program with essential protections due to the new unique identifier on the cards.”

In fact, “more than half of healthcare claims CMS is processing now include the new MBI, demonstrating a smooth transition to the new cards,” CMS notes. “Healthcare providers submitted 58 percent of all Medicare Fee-for-Service (FFS) claims with an MBI for the week ending January 11th.”

If your patients claim not to have received a new Medicare card and number, direct them to 1-800-MEDICARE or the MyMedicare.gov website to request a replacement. And you can give them their new number that you look up.

Important: Keep in mind that the MBIs do not contain “Os,” but instead utilize zeros, eliminating any confusion on the matter. Each unique MBI consists of 11 randomly-generated alphanumeric characters. CMS uses the numbers 0-9 and uppercase letters from A-Z in the MBIs, according to MLN Matters SE18006.

Important:  An exception to this rule is that the letters S, L, O, I, B, and Z are not included. CMS excluded these letters to avoid confusion.

Get the MBI details at www.cms.gov/newsroom/press-releases/cms-finalizes-new-medicare-card-distribution-ahead-deadline-accelerating-fight-against-medicare.