Author Topic: Claims that we submitted to Medicare returned to us due to NPI errors.  (Read 1339 times)

Michele

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Question
Hi Michele,
I have had some hard copy claims that we submitted to Medicare returned to us due to NPI errors. We are currently putting the Doctors Medicare Provider # in the shaded area of box 24j and our group # in box 33b. The information that Medicare has returned to us states that the shaded area of box 24j should include a legacy PIN number for the performing/rendering provider and that it should be a 9-digit numeric number. The Medicare Provider #'s that I have are not 9 digits and they do include alpha characters as well as numeric. Medicare also states that box 33b should include the Group PIN # which is one alpha and 3 numeric. I have neither the 9 digit numeric legacy PIN or the Group PIN. Can you tell me where I can obtain this information.
Thanks,
Cindy

Answer
Hi Cindy,
From what you have described you are filling out the CMS form properly. The individual provider's NPI number goes in box 24J (bottom - not shaded) and the individual provider's Medicare Provider number should go in box 24J (top - shaded area). Then the billing provider's NPI should go in box 33A and the group Medicare Provider number should go in box 33B (shaded).

Since the number that you are using as the Medicare Provider Number is not 9 digits (which is what they are stating it should be) you are going to have to contact Medicare and ask them what they consider to be the Provider number for your provider. It should not have changed from what you were using. However, the only way to find out what they want is to ask them.
Good luck
Michele
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