Advanced Search

Home Health & Hospice Week

Industry Notes:

Edit Delay For Docs May Make Your PECOS Job Harder

Published on Wed Nov 03, 2010

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 [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Home Health & Hospice Week

View All