Part B Insider (Multispecialty) Coding Alert

Published on Tue May 17, 2011 PDF

You can put PECOS edits a little further down on your crowded priority list. CMS "has not yet determined when it will begin to apply the expanded edit for ordering/referring provider claims," the agency says in an e-mail message to providers.

Background: These edits are applicable to ordering/referring providers that do not have a record in the Provider Enrollment, Chain, and Ownership System (PECOS). Currently, providers receive informational edits about ordering/ referring physicians not in PECOS. In the edits' next phase, claims will reject due to the problem.

Stay tuned: "CMS will give providers ample notice before the ordering/referring provider claim edit is applied," the agency pledges.