• CMS Announces PECOS Implementation Delay for Home Health


    Temporary Delay in Implementing Ordering and Referring Denial Edits

    According to a release from CMS this morning,  due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed.  It will not begin enforcing claims edits on May 1, 2013.

    Here is an excerpt from the CMS Medicare FFS Provider e-News on the Medicare Learning Network®.

    These edits would have checked the following claims for an approved or validly opted-out physician or non-physician who is an eligible specialty type with a valid individual National Provider Identifier (NPI). If either of these were missing or incorrect, claims would deny.

    Medicare Part B claims from laboratories, imaging centers and Durable Medical Equipment, Orthotics, and Supplies (DMEPOS) that have an ordering or referring physician/non-physician provider; and  Part A Home Health Agency (HHA) claims that require an attending physician provider.

    CMS will advise you of the new implementation date in the near future. In the interim, informational messages will continue to be sent for those claims that would have been denied had the edits been in place.

    Click here for the link to the full CMS Announcement.