PECOS DELAY

PECOS edits were set to go live on May 1, 2013, however due

to technical issues it has been delayed.

This is good news for the suppliers because you now have more time to

get those referring physicians that are not enrolled in PECOS, enrolled and

educated on the PECOS policy.   .    

Do not stop preparing and pay attention to those

alerts.  The helpful tips listed below

are still important to follow until the new deadline is set.     

Helpful tips for PECOS alerts/denials:  (You

need to be working on this now!)

  1. Create a list of those physicians that are not PECOS

    certified.

  2. Contact the physician letting them know they are not PECOS

    certified which means you can no longer service their patients and cannot

    take future referrals they are registered in PECOS.

  3. Check to make sure you are using the individual NPI not

    the physician group NPI.

  4. Do not use other group NPIs such as hospitals, clinics,

    etc.

  5. Do not use your own NPI for referring physicians.
  6. The denial is date of bill driven—hold your claim until

    physician is approved for PECOS, then bill original date of service.

  7. Not only will DMEPOS deny but any referral will deny

    including laboratory, x-ray’s, specialty services, etc.

  8. Teach physicians about the PECOS requirements.

Remember:  Capped rentals are included in the ordering & referring edits and

will be denied on or after May 1st if the physician is not PECOS

certified.    VA Military

physicians are eligible to order and refer DMEPOS services.  If they are not certified yet, they can use

the internet-based PECOS or complete the CMS-8550 paper form.  They will not be submitting claims to

Medicare for services they furnish to Medicare patients.  *The issue of VA physicians is being

addressed with PECOS administration.

For more information contact Peggy Walker at [email protected] or call

800-401-3643 or Ronda Buhrmester at [email protected]

or call 888-665-6518.

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/InternetbasedPECOS.html