Tuesday, December 8, 2009

How long will it take to get an NPI?

Question: How long will it take to get an NPI?
Answer: We cannot predict the amount of time it will take to obtain a National Provider Identifier (NPI) because several factors come into play. Such factors include the volume of applications being processed at a given time, whether the application was submitted electronically or on paper, and whether the application was complete and passed all edits. We expect that a health care provider who submits a properly completed electronic application could have its NPI in 10 days.

Aprilaire Humidifier


Commercial Refrigerators

What is the format of the NPI?

Question: What is the format of the National Provider Identifier (NPI)?

Answer : The National Provider Identifier (NPI) is all numeric and is 10 positions in length: the first 9 positions are the identifier and the last position is a check digit. The check digit helps detect invalid NPIs. There is no embedded intelligence in the NPI with respect to the health care provider that it identifies.
Home Security Systems

Patio Furniture

Refrigerator Water Filters

Is a health care provider required to obtain a National Provider Identifier (NPI)?

Question: Is a health care provider required to obtain a National Provider Identifier (NPI)?

Answer : Yes. Under the NPI Final Rule (69 FR 3434), health care providers who are covered entity under HIPAA were required to obtain an NPI and to use it to identify itself as a health care provider in HIPAA transactions as of May 23, 2007. Small health plans were required to use the NPI since May 23, 2008. A health care provider is a covered entity if it transmits any health information in electronic form in connection with a transaction for which the Secretary has adopted a standard. For example, any health care provider (individual or organization) who sends electronic health care claims to a health plan(s),is a covered provider and must obtain an NPI. Health care providers who are not covered providers may elect to apply for NPIs, but are not required to do so. For the latest information regarding NPI issues for health care providers, visit this website: www.cms.hhs.gov/NationalProvIdentStand/
Heart Surgery

Ceiling Fan

pittsburgh steelers merchandise

Can ICD-9-CM procedure codes be reported on hospital outpatient claims?

Question: Can ICD-9-CM procedure codes be reported on hospital outpatient claims?

Answer : NO. ICD-9-CM procedure codes were named as the HIPAA standard code set for inpatient hospital procedures. The ICD-9-CM procedure codes were not named a HIPAA standard for procedures in other settings such as hospital outpatient services or other types of ambulatory services. Hospitals may capture the ICD-9-CM procedure codes for internally tracking or monitoring hospital outpatient services; but when conducting standard transactions, hospitals must use HCPCS codes to report outpatient services at the service line level and the claim level, if the situation applies. Even though an ICD-9-CM procedure code qualifier is available, in addition to a HCPCS code qualifier, at the “situational” claim level segment, the Transactions and Code Sets regulation states that ICD-9-CM procedure codes is the adopted standard code set for hospital inpatient services.
Hotels in Augusta GA

Vending Machines

Ultrasound Service Training

How can a health care provider apply for and obtain a National Provider Identifier (NPI)?

Question: How can a health care provider apply for and obtain a National Provider Identifier (NPI)?
Satellite Internet Service Providers

Lechuza Planters

Content Solutions
Answer : A health care provider may apply for an NPI in one of three ways:

1. Apply through a web-based application process. The web address to the National Plan and Provider Enumeration System (NPPES) is https://nppes.cms.hhs.gov.

2. If requested, give permission to have an Electronic File Interchange Organization (EFIO) submit the application data on behalf of the health care provider (i.e., through a bulk enumeration process). If a health care provider agrees to permit an EFIO to apply for the NPI, the EFIO will provide instructions regarding the information that is required to complete the process. More information on this option is available at: www.cms.hhs.gov/NationalProvIdentStand/04_education.asp#TopOfPage

3. Fill out and mail a paper application form to the NPI Enumerator. A copy of the application form (CMS-10114), which includes the NPI Enumerator’s mailing address, is available only upon request through the NPI Enumerator. The NPI Enumerator’s phone number is 1-800-465-3203 or TTY 1-800-692-2326.

When applying for an NPI, providers are encouraged to include their Medicare identifiers, but also those issued by any other health plans. If reporting a Medicaid identification number, include the associated State name. The legacy identifier information is critical for health plans in the development of crosswalks to aid in the transition to the NPI. Once the NPI application information has been submitted and the NPI assigned, NPPES (or an EFIO, if the health care provider was enumerated by way of an EFIO) will send the health care provider a notification that includes their NPI. This notification is proof of NPI enumeration and provides the information that will enable trading partners to verify a health care provider’s NPI.