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Medicare Compliance & Reimbursement

Industry News:

CMS Delays PECOS Denial Deadline

Published on Tue Nov 23, 2010

Good news: You won't face claims denials in January due to PECOS edits, thanks to an updated CMS directive on the issue. Background: Currently, if you submit claims for services or items ordered/referred and the ordering or referring physician's information is not in the MAC's claims system or in PECOS, your practice will get an informational message letting you know that the practitioner's information is missing from the system. It was previously announced that CMS would start denying these claims on Jan. 3, but that is no longer the case. On Nov. 29, CMS distributed an email that the agency referred to as an "Important Update on PECOS and Ordering/Referring," in which the agency noted, "While there are some rumors that the edits will be turned on in January, we want to reiterate that CMS has not announced any date (January 3 or otherwise) as to when ordering/ referring edits [...]
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