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Home Health & Hospice Week

Industry Note:

CMS Changes Listing Format For Ordering Physician File

Published on Wed Nov 02, 2011

You may have to tweak your procedures for checking whether your referring physicians are in Medicare's PECOS system. Background: Although it still hasn't implemented the postponed claims edits for physician enrollment in PECOS, CMS wants docs who order and refer for Medicare services to be enrolled in the online system. You should be checking each of your physicians against the PECOS enrollment database and NPI registry, experts advise (see Eli's HCW, Vol. XX, No. 35, p. 272). Now that registry will look different, however. "In response to concerns raised by the provider community, CMS will no longer post the complete NPI on the ordering & referring reports," the agency says in an e-mail message to providers. The pending and enrolled PECOS reports now will contain only the last four digits of the docs' NPIs. Links to the reports are in the "Downloads" section online at www.cms.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp.
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