Saturday, October 6, 2007

How quickly does NPPES update crosswalk

Scenario: Office is submitting claims and gets rejections M340, M379, M341, M380, M343, M381, M347, or M382 which are all NPI error messages from Medicare. These files are deleted by Medicare at the EDI department. (or if your state is not deleting them you will be told it's informational meaning you should fix this issue as soon as possible but Medicare will still process your claim)

The office will get Prepass reports from Medicare that state informational somewhere on the report along with the words file is deleted (these are not good things). This can mean several things:
1. The provider is not listed on the crosswalk
*Use this information to Validate a Providers NPI number

2. The provider is listed in NPPES however; the claims are not transmitting with the correct NPI#'s in the right areas of the electronic claims
* call your practice management software or reference documentation to identify the following fields in your software that corresponds with the correct Loop #.

Billing Provider level (2010AA)- M340 & M379
Pay To Provider level (2010AB) - M341 & M380
Rendering Provider level (2310B) - M343 & M381
Rendering Provider level (2420A) - M347 & M382

To contact NPPES:
The NPI Enumerator is responsible for assisting health care providers in applying for their NPIs and updating their information in NPPES.
1-800-465-3203 (NPI Toll-Free) 1-800-692-2326 (NPI TTY)
NPI EnumeratorPO Box 6059Fargo, ND 58108-6059

Updates to the providers NPI #'s through NPPES can take from 8-10 days.

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