NPI and PIN, UPIN update of CMS 1500

·    Unprocessable section – deleted PIN reference for Items 33, 17, 17a, 17b and 20.

·    Updated definition of incomplete or invalid information to remove reference to UPIN and PIN.

·    Updated all electronic field examples.

·    Item 17 – removed UPIN information.

·    Item 17a – updated to explain this field is no longer used.

·    Item 17b – removed note regarding “when NPI is mandated:

·    Item 19 – removed “UPIN” reference.

·    Item 24i – removed. This item is no longer used by Medicare.

·    Item 24j – deleted information regarding PIN. Removed note regarding the shaded portion.

·    Item 25 – removed reference to PIN.

·    Item 32 – removed PIN information.

·    Item 32b – updated to show this field is no longer required.

·    Item 32a – removed information about effective date of NPI.

NPI Updates NPI Processing Update

BlueCross BlueShield is pleased to announce that beginning December 3, 2007, claims submitted with both an NPI and Legacy ID will be processed under the NPI. This is an important milestone in our eventual transition to processing all claims by using your NPI exclusively. We would like to remind providers that you may continue to submit claims with various combinations of identifiers up to May 23, 2008. After this date, we will only accept and process claims using your NPI.

To summarize, you may continue to submit:

• Legacy ID and NPI up to May 23, 2008, at which time NPI will be used exclusively.
• Legacy ID only up to May 23, 2008, at which time NPI will be used exclusively.
• NPI only, no action necessary, unless you’ve received a warning message. Response Report Warning Messages

If you have received any of the following warning messages on your electronic response reports, please address them immediately by performing the required action. Message Required Action
H372 Fax billing NPI to HealthNow at 716-887-2056
Fax billing NPI to Network Services
H373 Fax rendering NPI to HealthNow at 716-887-2056
Fax rendering NPI to Network Services
H376 Billing NPI not tied to TP number Contact Network Services; please research your Trading Partner ID # and
NPI prior to calling
H377 Billing NPI not on payer provider file Fax billing NPI to Network Services
H378 Billing NPI not set up for this transaction