Medicare Part B Informational Edits Will Be Set To Reject

Since October 2006, Florida providers submitting invalid NPI/legacy ID combinations have been receiving informational edits on their Batch Detail Control Listing.

Effective September 10, 2007, these edits will become live and cause your claims to reject.

If you are currently receiving informational NPI edits, you must correct them by this date.

NPI Tips

• Confirm your NPPES information is correct - https://nppes.cms.hhs.gov

• Be sure you include all Medicare legacy provider identification numbers (PINs) associated with the NPI number in the other identifier section of the NPPES application.

• If you are part of a group, the group NPI belongs in the 2010AA Billing provider loop and your individual doctor’s NPI belongs in the 2310B Rendering provider loop.

• If you are not part of a group, your individual doctor NPI belongs in the 2010AA Billing provider loop. Do not submit a 2310B Rendering provider loop.

• If your tax ID number has changed, you many need to submit a Medicare enrollment application (CMS-855).

For additional information, please contact Medicare EDI at (904) 354-5977 option 2