Important Medicare Info: 2010

The following is an important Medicare update which concerns all Part B Trading Partners.

Why am I receiving edits with Medicare?
You are receiving the edit because you have a legacy number or UPIN on your claim. The term “legacy number” is the same as PTAN, Medicare PIN, or Medicare Provider Number. These edits were implemented on January 7, 2008, and are in preparation for Phase III of NPI. Phase III is scheduled to be implemented on May 23, 2008.

What will happen to my claim? Will it be deleted? Will it be denied by Medicare?
No – at this time these edits on your BDCL are strictly INFORMATIONAL. If M402, M403, M404, M405, or M406 is the only edit you receive on the claim, your claim will be passed on to the Medicare Part B claims processing system for payment. Your claim will NOT be deleted and it will not be denied by Medicare for these edits.

What can I do to stop receiving the edit?
Send ONLY the NPI in your EMC file and remove all legacy numbers (also referred to as UPIN, PTAN, Medicare PIN, Medicare Provider Number) from your EMC file.

Note: Do not remove your Tax ID from your EMC file. If the Tax ID is removed, the claim will reject.

When will these edits change to a rejection/delete?
On May 23, 2008, these edits will change to a rejection. If, after that date, you send a legacy number in your EMC file, your claims will be rejected/deleted and they will not be passed on to the Medicare Part B claims processing system for payment.