Medicare to Deny Claims Without Provider Identification

Medicare claims that don’t contain a valid national provider identifier for the ordering or certifying healthcare professional starting Jan. 6.

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The new practice will affect claims from clinical laboratories for ordered tests, imaging centers for ordered imaging procedures and Medicare Part A home health agencies. It will also apply to claims for ordered items from suppliers of durable medical equipment, prosthetics, orthotics and supplies.

The provision generally only impacts hospitals or home health agencies enrolled as durable medical equipment suppliers, according to an AHA News report.

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