Part B Insider (Multispecialty) Coding Alert

Physician Note:

CMS Offers NPI Advice

Plus: CMS clarifies pulmonary rehab coverage.

National provider identifiers (NPIs) have been around long enough for most practices to know theirs by heart"but when it comes to entering an individual vs. a group NPI, things can get confusing. CMS aims to fix these types of problems with a news blast that sets providers in their places.

"When billing Medicare, Home Health Agencies (HHAs) must use the individual National Provider Identifier (NPI) of the physician who orders/refers services, not the NPI of the physician's group practice," CMS tells physicians in a new listserv message. "If an HHA asks for your NPI, be sure to provide your individual NPI."

Physicians who don't know their individual NPI can look it up in CMS's NPI registry at https://npiregistry.cms.hhs.gov/NPPESRegistry/NPIRegistryHome.do, CMS notes.

If you need more help getting your physicians to comply with billing requirements, you can point them to a newly revised CMS fact sheet, "Medicare Enrollment Guidelines for Ordering/ Referring Providers."

"You need to ensure you have an NPI and a current Medicare enrollment record in Internet-based PECOS that includes your NPI," CMS tells physicians in the fact sheet at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedEnroll_OrderReferProv_FactSheet_ICN906223.pdf. The fact sheet contains directions on applying for an NPI and enrolling in PECOS.