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Home Health & Hospice Week

Industry Notes:

Doc Claim Edits May Help Your PECOS Edit Efforts

Published on Fri Jan 14, 2011

Physicians may not be paving the way for your PECOS edits that start in July, but at least they should help once the edits start. That's because PECOS edits on their own claims will start at the same time. Background: Starting in July, the PECOS edits will reject a claim if the claim doesn't contain the ordering or referring physician's National Provider Identifier (NPI) and/or the physician isn't enrolled in Medicare's PECOS online system. The PECOS edits for physician claims were supposed to start this month, which would have helped speed docs' enrollment in the PECOS system. But CMS postponed the edits until July with Transmittal No. 825 (CR 6417) at www.cms.gov/transmittals/downloads/R825OTN.pdf.
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