NPI in CMS 1500 32 and CMS 33

When is an NPI entered in block 32 and how do I share my NPI with Medicare?

Medicare does not require an NPI in block 32a nor a legacy number in 32b. If you are using the new CMS-1500 version 08-05, and if you previously populated boxes 17a (referring provider), 24j (rendering provider), and 33 (billing provider) with your legacy number, you should begin using your NPI also. If the information in block 33 (billing) is different than block 32 (service facility), you should populate block 32 with the address information. There is no need to notify Medicare of your NPI number, you only need to send the number on your claim

Do I need a National Provider Identifier (NPI) to make changes to my Medicare enrollment information?

Yes, Medicare providers must provide their NPIs when making any changes to their Medicare enrollment information.

If provider Y has both Type 1 and Type 2 NPIs do we need to place Type 1 or Type 2 on the CMS 1500?

The NPI assigned to a group is to be reported in the billing provider portion of the new CMS-1500 (08/05) and the NPI of the member of a group who furished the care being billed is to be reported in the rendering provider section of the new CMS-1500. There are no fields for NPI in the pre-8/05 version of the CMS-1500. Medicare will not begin to accept the new 1500 forms until 1/2/07 and will stop accepting claims on the older version of the 1500 beginning April 1, 2007.

No comments:

Medical Billing Popular Articles