decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 1 (January)
Medicare delays new enrollment policy for ordering providers
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Article Overview
This article explains a CMS delay in implementing a Medicare enrollment policy that affects ordering and referring providers for certain claims. It is relevant to billing staff, compliance teams, physicians, and suppliers who need to understand the timing of the policy, the provider groups impacted, and the role of PECOS enrollment in Medicare claim acceptance. The piece also points to the CMS transmittals that announced the change and discusses the operational impact on practices that order covered items or services.
Why This Topic Matters
Practices and suppliers that submit Medicare claims need to know whether ordering or referring providers are properly enrolled so claims are not disrupted when the policy takes effect. The article helps readers understand who may be affected and why enrollment data review matters for billing continuity.
What You Will Learn
- How CMS delayed enforcement of a Medicare enrollment policy for ordering and referring providers
- Which broad provider groups and claim types may be affected
- Why PECOS enrollment status matters for Medicare claim processing
- How CMS communication and transmittals relate to the policy change
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance staff
- Physicians
- Durable medical equipment suppliers
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