E/M Coding Alert - 2010 Issue 7
ENROLLMENT: CMS Delays Ordering/Referring PECOS Regulation Until 2011
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Article Overview
This article covers a CMS enrollment update affecting Medicare ordering and referring requirements, including a delay in implementation timing and reminders about PECOS registration. It also discusses general enrollment processing issues, electronic versus paper submission, and handling practitioner enrollment when providers move or change practice locations. The piece is relevant to billing staff, practice administrators, enrollment specialists, and providers who manage Medicare enrollment records.
Why This Topic Matters
It helps practices understand a temporary change in Medicare enrollment enforcement timing and highlights administrative steps that affect whether claims can be processed without interruption. It also provides broader context on keeping practitioner enrollment information current in CMS systems.
Article Sections
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CMS delays ordering and referring enforcement timing
This section explains the announced postponement of implementation timing for Medicare ordering and referring enrollment enforcement. It frames the change in the context of CMS communications and the PECOS system.
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Avoid PECOS lags
This section discusses general enrollment processing issues and CMS encouragement to use electronic PECOS. It also covers common reasons paper enrollment materials may be delayed.
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Get New Docs Into PECOS
This section addresses updating enrollment records for a newly hired physician who changes states while remaining within Medicare enrollment processes. It focuses on maintaining current enrollment information across locations.
What You Will Learn
- How CMS described the timing change for ordering and referring enrollment enforcement
- Why PECOS enrollment status matters for Medicare enrollment records
- Common causes of delays in paper Medicare enrollment processing
- Why CMS encourages electronic enrollment submission
- How practitioner enrollment records may be affected by changes in state or practice location
Who Should Read This
- Medical billing staff
- Practice administrators
- Enrollment specialists
- Healthcare providers
- Compliance staff
Codes Discussed
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