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Back  RFI # 465: 278 NPI Implementation 2010E

Formal vs. Informal Help Informal Formal

Submitter

Linda Milton

Description

The 278 doesn't offer much to resolve a one NPI to multiple legacy IDs. In studying the Combined May 2000-004010X094 and October 2002 004010X094A1 Health Care Services Review Implementation Guide, p. 155-6 references Loop 2010E Service Provider Supplemental Identification REF 01 (DE 128) Reference Identification Qualifier =ZH Carrier Assigned Reference Code. Can this be used to house the "referred to" or "service provider" plan specific legacy ID (UMO Assigned) when NPI is implemented in the 2010E NM108 NM109?

Submitter Assigned Keywords

278 NPI Implementation

Response

Reference from CMS FAQ on NPI:
After May 23, 2008 for standard transactions to or from small health plans, and after May 23, 2007 for all other standard transactions:
* A covered health care provider must use only its NPI to identify itself as a health care provider in standard transactions. If any of its subparts have been assigned NPIs, the covered health care provider must ensure that the subparts use only their NPIs to identify themselves as health care providers in standard transactions.

Additional Note from the workgroup:
The X094A1 is not a financial transaction and therefore, the tax ID would not be needed. The 5010 guides do not have the tax ID as an option.
Submission 10/17/2006
Status Date 10/23/2006
Status F - Final
Primary References
Document 004010X094A1
Section2010E
Page155
Set ID004010
Loop2010E
Segment Position180
Segment ID128
Industry NameReference Identification Qualifier
External Code ListCarrier Assigned Reference Num
Code ValueZH