Part B Insider (Multispecialty) Coding Alert

PHYSICIAN NOTES:

CMS Hasn't Made New PECOS Ruling Legal Yet,Analysts Say

Plus: CMS creates crosswalk that leads you from ICD-9-CM to ICD-10-CM diagnosis codes.

Keep an eye on the Federal Register as you use Medicares Internet-based Provider Enrollment,Chain and Ownership System (PECOS), analysts who have reviewed the process tell the Insider.

Background: CMS issued a press release on April 1 from Valerie Haugen, a director with CMS, announcing that the person filling out the PECOS form need not be the physician or non-physician practitioner, but may be an employee of the provider or supplier organization, or an employee of a separate organization.

The update: During an April 7 CMS Open Door forum, CMS reiterated its position that the physician doesnt need to personally fill out the PECOS form. However, CMS press releases and phone conferences dont make the rule legal, says Robert Burleigh, CHBME, president of Brandywine Healthcare Consulting in West Chester, Pa.

A CMS regulation has to be in the Federal Register before its totally legal, Burleigh says. The Healthcare Billing and Management Association (HBMA) is having conversations with CMS officials to say that issuing a press release is not enough. Although its obvious what CMSs intent is, the law has to catch up with it, he advises.

The Insider will continue to follow this issue and offer updates as they are available.