Find-A-Code Focus Newsletter

Ordering and Referring Denial Edits Implemented January 6, 2014

January 05, 2014

CMS will instruct contractors to turn on Phase 2 denial edits on January 6, 2014. These edits will check the  following claims for a valid individual National Provider Identifier (NPI) and deny the claim when this information is invalid:

  • Claims from clinical laboratories for ordered tests;
  • Claims from imaging centers for ordered imaging procedures;
  • Claims from suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) for ordered DMEPOS; and
  • Claims from Part A Home Health Agencies (HHAs).

 For more information:

  • MLN Matters® Article #SE1305, “Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency (HHA) Claims (Change Requests 6417, 6421, 6696, and 6856)”

---

Find-A-Code will be updating our Find-A-NPI tool to show the Medicare Approved status of the providers and will be enhancing the tool to allow you to enter multiple NPI numbers as search criteria.

Watch for the update to be released later this week.

Happy coding.

- the Find-A-Code Staff
share
 

More Items in January 2014


To view more items select a month from our "Items by Month" list.

Or view documentation, coding and billing articles.

 
News Items by Month
February 2022- 1
2021 - View
2020 - View
2019 - View
2018 - View
2017 - View
2016 - View
2015 - View
2014 - View
2013 - View
2012 - View
2011 - View
2010 - View
2009 - View
2008 - View
demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.