Ophthalmology and Optometry Coding Alert

Question: We recently received a remittance advice and the number on it didn’t match the number the patient gave us – I assume it includes his new ID number, but we are confused. Can you advise?

Codify Subscriber

Answer: As of October, Medicare remittance advices include patients’ new identifiers, which replace their prior ID numbers due to the government’s interest in eliminating Social Security numbers from identification cards.

The new Medicare Beneficiary Identifier (MBI) is completely different from the old SSN based Health Insurance Claim Number (HICN). The MBI is generated randomly so has no intelligence or special meaning behind any of the characters.

The MBI will be 11 characters in length and comprised of randomly generated numbers and uppercase letters. It will not include any special characters or the letters S, L, O, I, B, or Z (to ensure that there are no questions about whether a character is a letter or a number).

Patients new to the Medicare program on/after April 1, 2018, receive only the new MBI. Multiple waves of mailings began in the spring of 2018 to send new cards to patients already enrolled in Medicare; the final mailing will take place in October. MACRA requires that all replacement cards be disseminated by April 16, 2019 (four years after passage of the bill).

What you do: Be sure to update your records to replace the HICN on file in the patient record with the new MBI number as patients come to your office. You can get this information from the patient, or through two other channels Medicare has established:

1. A secure portal on the website of the Medicare Administrative Contractor (MAC) that processes claims for your jurisdiction. The MBI will be available in this manner after completion of the mailing wave. To help protect this confidential information, some MACs may require you to log into their site per your enrolled provider status before allowing you to access the tool.

2. Remittance Advices (RA) you receive from the MAC with your Medicare payments.

This option pushes the MBI out to you, so use them to cross-check your information.

Also important: There is no formal testing period for the new MBI cards since either the old HICN or the new MBI can be used from April 2018 until December 31, 2019. Beginning January 1, 2020, only claims with the new MBI will be accepted. Patients may use their new cards as soon as they start receiving them in the mail.