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11/3/2009 - Phase I Underway: Editing the Ordering/Referring Provider in DMEPOS Claims

Phase 1 of the DMEPOS Claims Edits is now underway.  Phase 1 will provide warning messages to prompt providers to take action prior to Phase 2 which will result in rejections beginning January 4, 2010. 

Phase 1 (October 5, 2009 through January 3, 2010), DMEPOS suppliers who report ordering/referring providers who do not pass both edits will receive an informational message on their remittance. (Paper billers will not receive an informational message.) The claims will be paid.

Phase 2 (January 4, 2010 and thereafter), DMEPOS suppliers who report ordering/referring providers who do not pass both edits will have their claims rejected.

For more information refer to Change Request 6421-Editing the Ordering/Referring Provider in DMEPOS Claims

 

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