Legacy Provider IDs Prohibited on Claims

When you report a Provider Legacy Identifier on Medicare CMS-1500 or CMS-1450 (UB-04) claims, Medicare will return them as unprocessable. CMS requires the NPI to be submitted on these claim forms. When returning these claims, your contractors will use an appropriate message and Remittance Advice Remark code, such as:

N257 Missing/incomplete/invalid billing provider primary identifier.

Note that contractors will not return claims in certain situations where an NPI is not required (e.g., foreign claims, deceased provider claims, and other situations as allowed by CMS in the future). Such claims will be processed with established procedures for such claims. Effective Date: 05/23/2008.