CMS Delays PECOS Phase 2 Implementation

On Thursday April 25th, 2013 CMS Announced that due to Technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed.

The 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.

  1. 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
  2. Part A Home Health Agency (HHA) claims that require an attending physician provider.

CMS Will announce the new implementation date in the near future. In the interim, information edits will continue to be sent for those claims that would have been denied had the edits been in place.

DME Billing Service
Provider of Professional
DME Billing Services

DME Billing News Feed:

Retrieved From:
April 25th, 2013