Home Health & Hospice Week

Industry Note:

CMS Changes Listing Format For Ordering Physician File

You may have to tweak your procedures for checking whether your referring physicians are in Medicare's PECOS system. Background: Although it still hasn't implemented the postponed claims edits for physician enrollment in PECOS, CMS wants docs who order and refer for Medicare services to be enrolled in the online system. You should be checking each of your physicians against the PECOS enrollment database and NPI registry, experts advise (see Eli's HCW, Vol. XX, No. 35, p. 272). Now that registry will look different, however. "In response to concerns raised by the provider community, CMS will no longer post the complete NPI on the ordering & referring reports," the agency says in an e-mail message to providers. The pending and enrolled PECOS reports now will contain only the last four digits of the docs' NPIs. Links to the reports are in the "Downloads" section online at www.cms.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Home Health & Hospice Week

View All