Home Health & Hospice Week

Industry Notes:

Edit Delay For Docs May Make Your PECOS Job Harder

July deadline for HHA PECOS edits will come faster than you think. Although CMS hasn't officially postponed the PECOS edits for physicians who receive referrals from another physician, the unofficial postponement is likely to increase headaches for home care providers. Background: Back in October, the Centers for Medicare & Medicaid Services delayed PECOS phase 2 edits for home health agencies until July 2011 (see Eli's HCW, Vol. XIX, No. 37, p. 290).Under phase 2 of the edits, Medicare will not reimburse claims unless the physician in the ordering/ referring slot is enrolled in PECOS. (Phase 1 informational edits for HHAs already began last month.) But CMS didn't delay PECOS edits for physician claims as well. MLN Matters article MM6417, which CMS distributed on Feb. 26, 2010, put the edits' effective date at Jan. 3, 2011. But now CMS says those physician claim edits will not start in January. "While there [...]
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