decisionhealth Newsletters, Part B News - 2009 Issue 7 (July)
New code is a warning to review referring/ordering physician information
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Article Overview
This article explains a CMS remittance advice update affecting claims that include ordering or referring physician information. It is aimed at billing and coding professionals who need to understand the general nature of the enrollment and claim-edit changes, the phased implementation approach, and why claims may be rejected or delayed. The discussion also points readers to CMS enrollment resources and the broader compliance implications for Medicare claims processing.
Why This Topic Matters
It helps practices recognize when Medicare claim problems may stem from provider enrollment or identifier issues rather than the service itself, supporting cleaner claim submission and fewer avoidable rejections.
What You Will Learn
- What the CMS remittance advice update is about
- Why ordering and referring provider information is being reviewed more closely
- How the change affects claim processing in general
- Where CMS directs providers to verify enrollment information
- What the phased rollout means at a high level
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Practice managers
- Compliance staff
Codes Discussed
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