Fiscal Intermediary Shared System (FISS) System Enhancement for Including Line Level Rendering Physicians/Practitioners National Provider Identifier (NPI) and Name Information in the Comprehensive Error Rate Testing (CERT) Resolution Record
Medicare needs to identify primary physicians/practitioners of service not only for use in standard claims transactions, but also for review, fraud detection, and planning purposes. In order to accomplish this, we must be able to determine the rendering physician/practitioner for each inpatient/outpatient service
billed to Medicare and store this information in our databases that serve as the source for data analysis. Prior to the implementation of the 5010 version of the 837 I, this information could only be collected at the claim level
in the other provider field.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: June 28, 2012
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