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CMS Releases Resource on Edits Impacting Ordering/Referring Providers

Coding Corner

The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.

CMS Releases Resource on Edits Impacting Ordering/Referring Providers
The Centers for Medicare and Medicaid Services (CMS) has announced the availability of a new article entitled, "Edits on the Ordering/Referring Providers in Medicare Part B Claims." The new article examines the requirement that Medicare providers and suppliers who order or refer items or services for Medicare beneficiaries must submit an enrollment application to Medicare by using the Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or by completing the paper enrollment application (CMS-855I). The article is available at www.cms.gov/MLNMattersArticles/downloads/SE1011.pdf.