tci Part B Insider - 2013 Issue 40

Physician Notes: CMS Sets Jan. 6 as Ordering/Referring Edit Implementation Date

If your practice put phase two of the Medicare ordering and referring edits on the back burner since CMS has delayed it so many times, you may want to turn your attention back to the subject. CMS announced on Nov. 6 that the edits will kick in on Jan. 6, 2014. “Effective January 6, 2014, CMS will turn on the edits to deny Part B clinical laboratory and imaging, DME, and Part A HHA claims that fail the ordering/referring provider edits,” CMS says in MLN Matters article SE1305. “Claims submitted identifying an ordering/referring provider and the...

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