Update: Expansion of the Current Scope of Editing for Ordering/Referring Providers for claims processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)
INDUSTRY NEWS TAGS: CMS
This Medlearn Matters article was revised on January 12, 2011, to clarify that CMS has not yet decided when it will begin to reject claims if an ordering/referring provider does not have a PECOS record. CMS will give providers ample notice before claim rejections begin. Recent revisions to CR 6417 require MACs to delay rejecting claims until receiving further direction from CMS.