Home Health & Hospice Week

Home care providers now have the delay to their PECOS edits in writing. Previously, the Centers for Medicare & Medicaid Services announced a delay to phase two of the edits that will check for a physician's NPI in the ordering/referring field. But CMS's written notice referred only to transmittals regarding physician claims, not home care provider claims.

Now CMS has said the PECOS edits for home care providers are on hold, too. An Oct. 8, 2010 memo had set the implementation date for the edits, which will reject claims not containing the NPI of PECOS-enrolled physicians, for July 5, 2011.

CMS "has not yet decided when it will begin to reject claims if an ordering/referring provider does not have a PECOS record," the agency says in newly updated MLN Matters article #6856. "CMS will give pro-viders ample notice before claim rejections begin."

Beware: Providers may get confused if they look at the original transmittal, however. CMS has not reissued the memo to reflect the date change. "The implementation and effective dates in this article are different than what is in the related CR," CMS says in the MLN Matters article. "The 'To Be Announced' implementation and effective dates in this article are the correct dates."

The revised article is at www.cms.gov/MLNMattersArticles/Downloads/MM6856.pdf.