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I'm in the same situation as you- working for a hospital.

I called CMS and was told that our individual therapists do not need an

NPI- we use the facility number. The person I spoke to said that the

NPI is to replace the provider ID's for those who currently submit

claims.

He said that the Billing office of the hospital would know who should

get the NPI or not because the e-transaction form would have a place for

it.

He said that if we don't currently include any identification for

therapists on our claims then we don't need to start doing so.

He said to just include the information on the e-transaction form that

is required. Currently, it's just the Attending provider, operating

provider, referring provider.

He said that the requirement of who gets " identified " has not changed-

the new requirement is that everyone who currently submits claims,

substitute their old identifier number for the new NPI.

The only time a therapist would need an NPI is if they do individual

billing; e.g. private pratice.

Anyone who does professional billing, requires one.

Our Billing Department also confirmed this with a reimbursement

consultant.

If you care to talk with the gentlemen that I did at CMS, it was:

Stanley Nachimson

.

Lori Stoddart, OTR

Inpatient Therapy Manager

Henry Ford Wyandotte Hospital

Wyandotte, MI

Lori

Lori

>>> Mourning.Todd@... 11/3/2006 11:04 AM >>>

Greetings group. Relating to the NPI number, I practice in a hospital

setting IP and OP and the hospital has a NPI number and all billing is

done through the hospital (Pretty standard stuff). Do I as a PT have

to

have a NPI number as an individual also? Some confusion here between

billing and myself.

Thanks for your thoughts.

Todd Mourning, PT

Manager of Therapy Services

Abraham Lincoln Memorial Hospital

315 8th Street

Lincoln, IL 62656

x 179

(fax)

mourning.todd@...

This message (including any attachments) contains confidential

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specific individual and purpose, and is protected by law. If you are

not the intended recipient,

you should delete this message. Any disclosure, copying, or

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taking of any action based on it, is strictly prohibited.

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Every PT also has to have their own NPI number (see Medicare's guidelines).

Their number stays with them at any location they work.

E. , DPT

Bodyscape Integrative Physical Therapy

Pasadena, CA

From: Mourning, Todd

To: PTManager

Date: Fri, 3 Nov 2006 10:04:21 -0600

Subject: NPI number

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<p>Greetings group. Relating to the NPI number, I practice in a

hospital<br>

setting IP and OP and the hospital has a NPI number and all billing is<br>

done through the hospital (Pretty standard stuff). Do I as a PT have to<br>

have a NPI number as an individual also? Some confusion here between<br>

billing and myself.<br>

<br>

Thanks for your thoughts.<br>

<br>

Todd Mourning, PT<br>

<br>

Manager of Therapy Services<br>

<br>

Abraham Lincoln Memorial Hospital<br>

<br>

315 8th Street<br>

<br>

Lincoln, IL 62656<br>

<br>

x 179<br>

<br>

(fax)<br>

<br>

<a href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>

<mailto:<a

href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>> <br>

<br>

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taking of any action based on it, is strictly prohibited.<br>

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Thanks very much for the info, Lori. I may try calling your CMS contact

next week because I just heard from our Billing Director that in

addition to the field for the hospital's NPI number at the top of the

new UB04, there is another box (#76) that requires the NPI of the

" attending provider " who has overall responsibility for the care of the

patient.

We're assuming that for patients who come with a physician referral,

we'll enter that physician's NPI, but for self-referred (non-Medicare)

patients, we're wondering if we could enter a PT NPI there. If so, our

therapists would need to get their own NPI's.

Is anyone familiar with this 2nd NPI when a hospital is the primary

provider? I'm hoping it might not be a required field.

Marilyn Mount, PT

Dept. of Rehab Services

University Hospitals Case Medical Center

11100 Euclid Ave.

Cleveland, OH 44106

Marilyn.Mount@...

Re: NPI number

I'm in the same situation as you- working for a hospital.

I called CMS and was told that our individual therapists do not need an

NPI- we use the facility number. The person I spoke to said that the

NPI is to replace the provider ID's for those who currently submit

claims.

He said that the Billing office of the hospital would know who should

get the NPI or not because the e-transaction form would have a place for

it.

He said that if we don't currently include any identification for

therapists on our claims then we don't need to start doing so.

He said to just include the information on the e-transaction form that

is required. Currently, it's just the Attending provider, operating

provider, referring provider.

He said that the requirement of who gets " identified " has not changed-

the new requirement is that everyone who currently submits claims,

substitute their old identifier number for the new NPI.

The only time a therapist would need an NPI is if they do individual

billing; e.g. private pratice.

Anyone who does professional billing, requires one.

Our Billing Department also confirmed this with a reimbursement

consultant.

If you care to talk with the gentlemen that I did at CMS, it was:

Stanley Nachimson

.

Lori Stoddart, OTR

Inpatient Therapy Manager

Henry Ford Wyandotte Hospital

Wyandotte, MI

Lori

Lori

>>> Mourning.Todd@... 11/3/2006 11:04 AM >>>

Greetings group. Relating to the NPI number, I practice in a hospital

setting IP and OP and the hospital has a NPI number and all billing is

done through the hospital (Pretty standard stuff). Do I as a PT have

to

have a NPI number as an individual also? Some confusion here between

billing and myself.

Thanks for your thoughts.

Todd Mourning, PT

Manager of Therapy Services

Abraham Lincoln Memorial Hospital

315 8th Street

Lincoln, IL 62656

x 179

(fax)

mourning.todd@...

CELEBRATING 140 YEARS of Caring for Cleveland.

The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of

the addressee only. University Hospitals and its affiliates disclaim any

responsibility for unauthorized disclosure of this information to anyone other

than the addressee.

Federal and Ohio law protect patient medical information, including

psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol,

and/or drug_dependence or abuse disclosed in this email. Federal regulation (42

CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit

disclosure of this information without the specific written consent of the

person to whom it pertains, or as otherwise permitted by law.

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Interestingly enough, this is the same information we got when we inquired

at the beginning of the year. And we are hospital based. Supposedly, each

individual therapist is supposed to get their own number even if the

hospital has its own number, since the therapist's number is portable and

will be in effect any place they choose to work. It sounds like CMS might be

giving out conflicting information.

Meryl Freeman, MS PT

Rex Healthcare

Raleigh, NC

NPI number

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<p>Greetings group. Relating to the NPI number, I practice in a hospital<br>

setting IP and OP and the hospital has a NPI number and all billing is<br>

done through the hospital (Pretty standard stuff). Do I as a PT have to<br>

have a NPI number as an individual also? Some confusion here between<br>

billing and myself.<br>

<br>

Thanks for your thoughts.<br>

<br>

Todd Mourning, PT<br>

<br>

Manager of Therapy Services<br>

<br>

Abraham Lincoln Memorial Hospital<br>

<br>

315 8th Street<br>

<br>

Lincoln, IL 62656<br>

<br>

x 179<br>

<br>

(fax)<br>

<br>

<a href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>

<mailto:<a

href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>>

<br>

<br>

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intended for a <br>

specific individual and purpose, and is protected by law. If you are not the

intended recipient, <br>

you should delete this message. Any disclosure, copying, or distribution of

this message, or the <br>

taking of any action based on it, is strictly prohibited.<br>

<br>

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We actually called NPI and were told that every practitioner who is

certified or licensed (MD, RN, PT, PTA ,OT ,COTA ,SLP ,CNA) must have an

NPI. But as was said earlier when we called CMS they stated just the

facility needed it for billing purposes. NPI stated at any time the

insurance you are billing may ask for copies of the NPI's of all healthcare

providers treating that patient for their records. My suggestion is to get

your NPI as it is free right now and if you change work venues you will

definitely need it anyways.

Bobbie Jo Sonnier,MS,PT

Manager, Therapy Services

HomeChoice Health Services, Inc

Memphis, TN

bsonnier@...

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Saturday, November 04, 2006 8:28 AM

To: 'PTManager '

Subject: RE: NPI number

Interestingly enough, this is the same information we got when we inquired

at the beginning of the year. And we are hospital based. Supposedly, each

individual therapist is supposed to get their own number even if the

hospital has its own number, since the therapist's number is portable and

will be in effect any place they choose to work. It sounds like CMS might be

giving out conflicting information.

Meryl Freeman, MS PT

Rex Healthcare

Raleigh, NC

NPI number

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<p>Greetings group. Relating to the NPI number, I practice in a hospital<br>

setting IP and OP and the hospital has a NPI number and all billing is<br>

done through the hospital (Pretty standard stuff). Do I as a PT have to<br>

have a NPI number as an individual also? Some confusion here between<br>

billing and myself.<br>

<br>

Thanks for your thoughts.<br>

<br>

Todd Mourning, PT<br>

<br>

Manager of Therapy Services<br>

<br>

Abraham Lincoln Memorial Hospital<br>

<br>

315 8th Street<br>

<br>

Lincoln, IL 62656<br>

<br>

x 179<br>

<br>

(fax)<br>

<br>

<a href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>

<mailto:<a

href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>>

<br>

<br>

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intended for a <br>

specific individual and purpose, and is protected by law. If you are not the

intended recipient, <br>

you should delete this message. Any disclosure, copying, or distribution of

this message, or the <br>

taking of any action based on it, is strictly prohibited.<br>

<br>

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The way that I understand it is that anyone defined as a covered entity is

eligible to receive an NPI. Eligible, in my opinion, doesn't mean has to.

BUT.

If you're eligible to receive one, regardless of whether you have to or not,

I think it just makes sense to do it. I think it's less of " do I have to "

and more of " why not " . If your employer is saying that you need one,

there's probably a reason that they need it.

The definition of " covered entity " is really the key here. If you are a

covered entity, you are required to have an NPI. If you're not, you don't

have to have one. To find out if you are a covered entity, go to:

http://www.cms.hhs.gov/apps/hipaa2decisionsupport/. Just a side note, the

rule is clear that just because you apply and receive an NPI, it doesn't

automatically make you a covered entity. But, if you ever become one,

you've got your number. the number stays with you wherever you go so you

don't need to keep reapplying if you become a covered entity.

Here is information from the CMS website on how to apply:

A health care provider will be able to apply for an NPI in one of three

ways:

.. Apply through a web-based application process. The web address is

https://nppes.cms.hhs.gov.

.. Prepare and send a paper application form to the Enumerator (Fox Systems).

A copy of the application form, which includes the Enumerator's mailing

address, will be available only upon request through the NPI Enumerator. The

Enumerator's phone number is 1- or TTY 1-.

.. With the permission of the health care provider, an organization may

submit a health care provider's application in an electronic file.

Tessa

Tessa L. Chenaille, CHC, CHP

President & CEO

Chenaille Compliance Consulting, LLC

5 Ross Street, Medford, Massachusetts 02155

P: F:

W: <http://www.chenailleconsulting.com> www.chenailleconsulting.com

" The time to fix the roof is when the sun is still shining. " - F.

Kennedy

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Saturday, November 04, 2006 9:28 AM

To: 'PTManager '

Subject: RE: NPI number

Interestingly enough, this is the same information we got when we inquired

at the beginning of the year. And we are hospital based. Supposedly, each

individual therapist is supposed to get their own number even if the

hospital has its own number, since the therapist's number is portable and

will be in effect any place they choose to work. It sounds like CMS might be

giving out conflicting information.

Meryl Freeman, MS PT

Rex Healthcare

Raleigh, NC

NPI number

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<p>Greetings group. Relating to the NPI number, I practice in a hospital<br>

setting IP and OP and the hospital has a NPI number and all billing is<br>

done through the hospital (Pretty standard stuff). Do I as a PT have to<br>

have a NPI number as an individual also? Some confusion here between<br>

billing and myself.<br>

<br>

Thanks for your thoughts.<br>

<br>

Todd Mourning, PT<br>

<br>

Manager of Therapy Services<br>

<br>

Abraham Lincoln Memorial Hospital<br>

<br>

315 8th Street<br>

<br>

Lincoln, IL 62656<br>

<br>

x 179<br>

<br>

(fax)<br>

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PT Manager,

I had something interesting pop up the other day. I evaluated a new patient

with neck pain due to a severe MVA resulting in a non displaced fracture of

C2 followed by 3 months in a halo and another 3 months in a rigid cervical

collar. At the suggestion of her Neurologist she saw a massage therapist

who was apparently also an RN. The MT/RN issued cervical exercises

including AROM LF, same with overpressure, and isometrics at her first visit

as well as delivering massage.

My question is whether exercise instruction is within the practice act of an

RN (unable to determine that by reviewing the act in CO) or allowed under

the scope of " practice " for a massage therapist. I guess RN's can be added

to the list of other healthcare practitioners who want to play PT. I

suppose that anyone can give exercise instruction if they are not billing

third party payers?

Incidentally the patient reported a marked increase in pain following the

exercise given to her by the RN and only sort term relief after the actual

massage. Big surprise to me. Cookie cutter exercises usually have that

effect.

I just thinks it's a shame that people who do not have the means to

determine what exercises will or will not help the patient are giving advice

on such things.

Joe Ruzich, PT

Pueblo, CO

..

<http://geo.yahoo.com/serv?s=97359714/grpId=1100781/grpspId=1705061347/msgId

=38118/stime=1162583402>

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I have read the CMS guidelines and it only makes reference to Healthcare

workers being " eligible " - no where does it state that it's required or

mandatory. That's why I called CMS myself to seek clarification.

Lori Stoddart

Henry Ford Wyandotte Hospital

Lori

>>> pilates4u@... 11/3/2006 6:25 PM >>>

Every PT also has to have their own NPI number (see Medicare's

guidelines). Their number stays with them at any location they work.

E. , DPT

Bodyscape Integrative Physical Therapy

Pasadena, CA

From: Mourning, Todd

To: PTManager

Date: Fri, 3 Nov 2006 10:04:21 -0600

Subject: NPI number

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<p>Greetings group. Relating to the NPI number, I practice

in a hospital<br>

setting IP and OP and the hospital has a NPI number and all billing

is<br>

done through the hospital (Pretty standard stuff). Do I as a PT have

to<br>

have a NPI number as an individual also? Some confusion here

between<br>

billing and myself.<br>

<br>

Thanks for your thoughts.<br>

<br>

Todd Mourning, PT<br>

<br>

Manager of Therapy Services<br>

<br>

Abraham Lincoln Memorial Hospital<br>

<br>

315 8th Street<br>

<br>

Lincoln, IL 62656<br>

<br>

x 179<br>

<br>

(fax)<br>

<br>

<a

href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>

<mailto:<a

href= " mailto:mourning.todd%40mhsil.com " >mourning.todd@<wbr>mhsil.com</a>>

<br>

<br>

This message (including any attachments) contains confidential

information intended for a <br>

specific individual and purpose, and is protected by law. If you are

not the intended recipient, <br>

you should delete this message. Any disclosure, copying, or

distribution of this message, or the <br>

taking of any action based on it, is strictly prohibited.<br>

<br>

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Please let me know if you hear otherwise. Our reimbursement consultant

agreed that we don't need them for our therapists. I'll have to ask

about the box #76. I'm assuming that it's the attending physician. We

don't have any " self-referrals " ; we only provide services under the

direction of a physician.

Lori

>>> Marilyn.Mount@... 11/3/2006 6:46 PM >>>

Thanks very much for the info, Lori. I may try calling your CMS

contact

next week because I just heard from our Billing Director that in

addition to the field for the hospital's NPI number at the top of the

new UB04, there is another box (#76) that requires the NPI of the

" attending provider " who has overall responsibility for the care of

the

patient.

We're assuming that for patients who come with a physician referral,

we'll enter that physician's NPI, but for self-referred (non-Medicare)

patients, we're wondering if we could enter a PT NPI there. If so,

our

therapists would need to get their own NPI's.

Is anyone familiar with this 2nd NPI when a hospital is the primary

provider? I'm hoping it might not be a required field.

Marilyn Mount, PT

Dept. of Rehab Services

University Hospitals Case Medical Center

11100 Euclid Ave.

Cleveland, OH 44106

Marilyn.Mount@...

Re: NPI number

I'm in the same situation as you- working for a hospital.

I called CMS and was told that our individual therapists do not need

an

NPI- we use the facility number. The person I spoke to said that the

NPI is to replace the provider ID's for those who currently submit

claims.

He said that the Billing office of the hospital would know who should

get the NPI or not because the e-transaction form would have a place

for

it.

He said that if we don't currently include any identification for

therapists on our claims then we don't need to start doing so.

He said to just include the information on the e-transaction form that

is required. Currently, it's just the Attending provider, operating

provider, referring provider.

He said that the requirement of who gets " identified " has not changed-

the new requirement is that everyone who currently submits claims,

substitute their old identifier number for the new NPI.

The only time a therapist would need an NPI is if they do individual

billing; e.g. private pratice.

Anyone who does professional billing, requires one.

Our Billing Department also confirmed this with a reimbursement

consultant.

If you care to talk with the gentlemen that I did at CMS, it was:

Stanley Nachimson

.

Lori Stoddart, OTR

Inpatient Therapy Manager

Henry Ford Wyandotte Hospital

Wyandotte, MI

Lori

Lori

>>> Mourning.Todd@... 11/3/2006 11:04 AM >>>

Greetings group. Relating to the NPI number, I practice in a hospital

setting IP and OP and the hospital has a NPI number and all billing is

done through the hospital (Pretty standard stuff). Do I as a PT have

to

have a NPI number as an individual also? Some confusion here between

billing and myself.

Thanks for your thoughts.

Todd Mourning, PT

Manager of Therapy Services

Abraham Lincoln Memorial Hospital

315 8th Street

Lincoln, IL 62656

x 179

(fax)

mourning.todd@...

CELEBRATING 140 YEARS of Caring for Cleveland.

The enclosed information is STRICTLY CONFIDENTIAL and is intended for

the use of the addressee only. University Hospitals and its affiliates

disclaim any responsibility for unauthorized disclosure of this

information to anyone other than the addressee.

Federal and Ohio law protect patient medical information, including

psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions,

alcohol, and/or drug_dependence or abuse disclosed in this email.

Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31

and 3701.243 prohibit disclosure of this information without the

specific written consent of the person to whom it pertains, or as

otherwise permitted by law.

==============================================================================

Go to http://henryford.com

We're Henry Ford. We Can.

HFHS

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plus, if you ever relocate you have your own NPI # and you can also do all

your credentialing on line at:_https://caqh.geoaccess.com/pmm/_

(https://caqh.geoaccess.com/pmm/) and that way you never have to complete

another 25+

pages of applications. Plus you can update it as you get new license,

professional liability insurance, etc.

Bubba Klostermann OT, CVE, CEAS

CEO, WORK & REHAB

4546 South 14 th

Abilene, Texas 79605

phone:

fax:

email: bubklo@...

This e-mail and any files transmitted with it are the property of WORK &

REHAB, are confidential, and are intended solely for the use of the

individual or entity to whom this e-mail is addressed. If you are not

one of the named recipient(s) or otherwise have reason to believe that

you have received this message in error, please notify the sender and

delete this message immediately from your computer. Any other use,

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e-mail is strictly prohibited.

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Why not just get one? It takes about 5 minutes online and you get the

number a few mniutes later. That's a lot less time thanit takes to

read CMSguidelines and call CMS about it.

Layman, PT

Moreno Valley, CA

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Joe,

Unfortunaetely, there is not much we can do here except EDUCATE our pts---it

is just as if that person would have gone to the internet and downloaded some

ex's and started doing them. However, the MT/RN shld have had some sense of

professional responsiblity and shld not have given advice on such ex's

especially knowing the pt's hx of cervical fracture. It is a shame. I always

tell my pts exercise is like medicine---and shld be dosed by a specialist---aka

PT----if you do too much you can make yourself worse----if you don't do enough

or do it right----it won't help----once I explain that to my pts and put in that

perspective----it really hits home w/ them

Good luck JOE!!!!

RON MASRI. MPT, ATC

Joe Ruzich wrote:

PT Manager,

I had something interesting pop up the other day. I evaluated a new patient

with neck pain due to a severe MVA resulting in a non displaced fracture of

C2 followed by 3 months in a halo and another 3 months in a rigid cervical

collar. At the suggestion of her Neurologist she saw a massage therapist

who was apparently also an RN. The MT/RN issued cervical exercises

including AROM LF, same with overpressure, and isometrics at her first visit

as well as delivering massage.

My question is whether exercise instruction is within the practice act of an

RN (unable to determine that by reviewing the act in CO) or allowed under

the scope of " practice " for a massage therapist. I guess RN's can be added

to the list of other healthcare practitioners who want to play PT. I

suppose that anyone can give exercise instruction if they are not billing

third party payers?

Incidentally the patient reported a marked increase in pain following the

exercise given to her by the RN and only sort term relief after the actual

massage. Big surprise to me. Cookie cutter exercises usually have that

effect.

I just thinks it's a shame that people who do not have the means to

determine what exercises will or will not help the patient are giving advice

on such things.

Joe Ruzich, PT

Pueblo, CO

..

<http://geo.yahoo.com/serv?s=97359714/grpId=1100781/grpspId=1705061347/msgId

=38118/stime=1162583402>

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