Effective this month, Medicare carriers will no longer accept "surrogate" physician identification numbers, according to Catalina Jovane, director of economic advocacy services for the Los Angeles County Medical Association.

Previously, providers and suppliers were allowed to bill Medicare using OTH000, a generic Unique Physician Identification Number, when the ordering or referring physician's UPIN was unknown or unavailable. Jovane says surrogate UPINs were originally intended for use when a physician had requested, but not yet received a UPIN. In practice, however, many physicians' billing systems use OTH000 as a default, even when a valid UPIN is available.

The Centers for Medicare and Medicaid Services directed the Medicare carriers to return claims with surrogate UPIN OTH000 as unprocessable.

Jovane recommends that physicians hold claims until a UPIN is obtained. CMS suggests obtaining UPINs from a list at www.upinregistry.com.

For more information on this new Medicare policy, call the LACMA Economic Advocacy Department at 213/226-0338 or the California Medical Association reimbursement hotline at 888/401-5911.