Part B Insider (Multispecialty) Coding Alert
How To Get Up To Speed On The New CMS-1500 Form
Make sure your software is ready to handle the changes This is the opposite of boxes 17 and 24i, in which the NPI goes after the other provider ID numbers.
Just when you think you-re prepared for the National Provider Identifier (NPI) conversion, there's another hurdle to clear. You-ll soon be faced with a new CMS 1500 Health Insurance Claim Form.
Deadline: By April 2007, you-ll have to use the new form to accommodate the new NPI numbers. In addition, a few small, non-NPI-related changes were made -to accommodate special needs,- the National Uniform Claims Committee (NUCC) says. The changes include:
- The bar code at the top of the form was removed.
- Box 17a was shortened. You-ll use this box for ID numbers other than an NPI.
- Box 17b was added. You-ll put the referring physician's NPI here.
- Shaded lines were added to Box 24. This change accommodates NPIs and other ID numbers during the transition period and also allows you to report supplemental information, the NUCC says.
- In Box 24C, -Type of Service- was changed to -EMG.- This is a payer-specific emergency indicator.
- Boxes 32 and 33 were divided into two boxes to accommodate the NPI. Don't miss: In boxes 32 and 33, it is the first part---a---of the box that you-ll use for the NPI number, and box -b- is for other provider ID numbers.
Contact your vendors now to make sure your software will be able to accommodate the new data fields and allow for printing adjustments. This -will likely be a very costly change for billers and providers because some software vendors will use this as an income avenue,- points out Cyndee Weston, executive director of the American Medical Billing Association.
Luckily, if you work with a clearinghouse, you may not have to update your software as quickly as if you submit claims on your own, says Gary Lindsay, president of Lindsay Technical Consultants Inc., a clearinghouse in North Mankato, MN.
Hidden trap: Even if you depend on a clearinghouse, there could be times when you need to drop to paper, and your CMS-1500 form would be incorrect if you don't update it now. You should test the new form before the final deadline, Weston suggests.
Carriers should already accept either the new or old 1500 form, CMS says, but you won't be required to use the new form until April 2, 2007.
Part B Insider (Multispecialty) Coding Alert
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