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Home Health & Hospice Week

Reimbursement:

CMS Moves Full Steam Ahead On PECOS Edits

Published on Fri Apr 27, 2012

You can't use ABNs for docs lacking PECOS records, final rule says. The PECOS-related claims denial catastrophe that CMS avoided last year is back on deck. Background: In May 2010, the Centers for Medicare & Medicaid Services published an interim final rule based on the Affordable Care Act, requiring physicians who ordered home health and certain other services to be enrolled in PECOS with a valid National Provider Identifier (NPI) number for claims to be paid. CMS planned to begin editing for docs' NPIs and PECOS information in January 2011. However, CMS postponed those edits indefinitely when physicians had inordinate difficulty enrolling in the system, among other problems. In a new final rule scheduled for publication in the April 27 Federal Register, CMS confirms its plans to move ahead with its NPI and PECOS requirements for physicians ordering home health services. And it confirms its plans to implement the dreaded [...]
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