As of May 23, 2008, the National Provider Identifier (NPI) will be required for all Health Insurance Portability and Accountability Act (HIPAA) standard transactions. This means that for all primary and secondary provider fields, only the NPI will be accepted and sent on all HIPAA electronic transactions (837I, 837P, NCPDP, DDE, 276/277, 270/271, and 835), paper claims (UB-04 and CMS-1500), and standard paper remittance advices. The reporting of Medicare legacy identifiers in any primary or secondary provider fields will result in the rejection of the transaction.
Now that the NPI is required on all Medicare claims in the primary provider fields, Medicare fee-for-service providers whose claims are being successfully processed with NPI/legacy pairs (and most are) should begin testing claims using the NPI alone. If the Medicare NPI crosswalk cannot match the NPI to the Medicare legacy number, the claim with an NPI-only will reject. If the claim is processed and the provider is paid, that provider should continue to increase the volume of claims sent with only the NPI. Access the NPI web page.
