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Ophthalmology and Optometry Coding Alert

Reader Questions:

NPI Deadlines Still Loom -- Be Prepared

Published on Mon May 05, 2008

Question: I'm still confused about what the May 23 deadline is for the NPI changes. What does that date really mean?Pennsylvania SubscriberAnswer: By May 23, you need to be able to submit Medicare claims with only the National Provider Identifier (NPI) in the primary fields.Caution: If your carrier has asked you to resubmit information on its 855 enrollment form, proceed with particular caution. If you haven't yet submitted a new 855, your carrier may be paying your claims by virtue of a "temporary crosswalk match" that links your legacy number and NPI. But the carriers' upcoming maintenance of the provider enrollment system may soon throw a wrench into that temporary fix, leaving you in a situation with carriers suddenly rejecting all claims.To avoid this tripping point, get the 855 form in -- and communicate with your carrier to ensure the system picks up the corrections in a timely manner.Simply turning in the corrected 855 -- without following up with your Medicare carrier -- may not be enough. CMS has warned that the process of revising the enrollment data "can take a number of months to accomplish." Resource: Learn more about NPIs at http://www.cms.hhs.gov/NationalProvIdentStand.-- Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CMM, CPC, CMSCS, consulting manager for Pershing, Yoakley and Associates in Clearwater, Fla.
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