Additional Information on Reporting an NPI
Posted: Mon Jan 28, 2008 11:50 am
Impact to You
Effective with claims received on or after May 23, 2008, Medicare will not pay for referred or ordered services or items; unless the fields for the name and NPI of the ordering, referring and attending, operating, other, or service facility providers are
completed on the claims.
What You Need to Know
CR 5890, from which this article is taken, provides that it is the claim/bill submitter‘s responsibility to obtain the ordering, referring and attending, operating other, service facility providers, or purchased service providers NPIs for claims. Further, it requires that the provider or supplier who is furnishing the services or items, after unsuccessfully attempting to obtain the NPI from these providers; report their own name and NPI in the
ordering/referring/attending/operating/other/service facility provider/purchased service provider fields of the claims.
What You Need to Do
Make sure that your billing staff is aware of this requirement to place the “furnishing†provider or supplier’s name and NPI in the appropriate fields and to use your name and NPI if those of the ordering/referring and attending/operating/other/service facility provider/purchased service providers are not obtainable.