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PECOS Deadline Moved Up

In February, CMS announced a new deadline of January 3, 2011 for the implementation of phase 2 of the enrollment requirements for getting ordering, referring providers into the PECOS system.

According to the Federal Register published May 5, 2010, the date has been moved up to July 6, 2010. The change is in interim status, with a 30 day comment rule, so we will not know for certain that July 6 is the new effective date until early June.

Claims with an ordering/referring physician name and NPI number require that the ordering/referring physician be enrolled in the Provider Enrollment, Chain and Ownership System (PECOS). Without this, claims will be denied. In ophthalmology and optometry, this affects any claims for diagnostic tests or ordered items such as postcataract eyeglasses.

To determine if you are already in the system, review the file found at:
http://www.cms.hhs.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp.
If you are listed on this list, no action is necessary.

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