Pediatric Coding Alert

Question: A friend at another pediatrician's office said they're signing up for PECOS to be sure they still get paid for certain things. What is PECOS, and is it something we should join?

Massachusetts Subscriber

Answer: PECOS (Provider Enrollment, Chain, and Ownership System) is the national repository of enrolled Medicare fee-for-service providers and suppliers. Pediatricians don't often enroll with PECOS -- and maybe aren't even familiar with the database " because they don't often work with Medicare patients. The Federal Register of May 5, 2010, however, directly addresses your specialty, so you're wise to get educated.

According to a new Federal Register rule, a pediatrician who orders or refers covered items or services for Medicare beneficiaries must have an approved enrollment record in PECOS. If you don't, you won't be reimbursed for the item or service. The ruling goes into effect July 6, 2010. "If you're practicing in an environment that will bring you in contact with children that may become or are Medicare patients, you'll want to read this rule," says Quinten A. Buechner, MS, MDiv, CPC, ACS-FP/GI/PEDS, president of ProActive Consultants, LLC, in Cumberland, Wis.

Learn more: To read the complete rule, go to http://edocket.access.gpo.gov/2010/2010-10505.htm. To learn more about PECOS, visit http://www.cms.gov  and search for PECOS.