CMS Sets July 5, 2011 Target for Implementation of PECOS Ordering/Referring Edits

CMS has issued a new transmittal to update its timeline for implementing claims edits that will deny claims for services ordered or referred by a physician or other eligible professional who does not have an approved file in PECOS. The transmittal confirms an earlier CMS list-serve announcement that CMS will not implement the edits (that could cause nonpayment for services ordered by practitioners not in PECOS) on January 3, 2011. Instead, CMS has established a new "implementation placeholder date" of July 5, 2011, which CMS notes will "give CMS more flexibility to determine the appropriate date for nonpayment of claims that fail the ordering/referring provider edits."

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