PART B REGS: CMS Transitioned Over 230,000 Providers' NPIs Into PECOS

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains CMS updates affecting Medicare providers and billing workflows, including PECOS enrollment and NPI record maintenance for ordering and referring practitioners. It also highlights CMS guidance urging earlier preparation for the ICD-10 transition and notes related system readiness efforts by providers, vendors, and payers.

Why This Topic Matters

The article is relevant to organizations that submit Medicare claims, manage provider enrollment data, or coordinate with ordering and referring practitioners. It also matters to practices and billing teams planning for ICD-10 system changes and testing requirements.

Article Sections

  1. PECOS enrollment and NPI record updates

    CMS discusses upcoming changes related to provider enrollment records, claims processing, and practitioner identifier data maintenance. The section focuses on Medicare enrollment system readiness and related administrative updates.

  2. Internet listing of ordering and referring practitioners

    CMS describes plans for an online listing of practitioners who can order and refer within Medicare. The discussion centers on what the list will contain and when it may become available.

  3. Get Ready for ICD-10

    CMS urges providers and vendors to prepare for the ICD-10 transition and outlines general timing and readiness considerations. The section emphasizes system preparation, testing, and coordination across billing workflows.

What You Will Learn

  • How CMS is updating Medicare provider enrollment records in PECOS
  • Why NPI maintenance matters for ordering and referring practitioners
  • What CMS said about a planned internet listing for ordering and referring practitioners
  • The general timeline and readiness concerns surrounding ICD-10 implementation
  • Which parts of the billing workflow CMS says may need preparation for ICD-10

Who Should Read This

  • Medical coders
  • Billing staff
  • Revenue cycle teams
  • Physician practices
  • Non-physician practitioner offices
  • Medicare providers
  • Clearinghouses
  • Healthcare IT and EHR/billing system vendors

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