tci Part B Insider - 2013 Issue 3

In other news...

If a new CMS podcast is any indication, the agency might soon follow through on its longstanding threat to deny claims that fail the ordering/referring provider edits. Although CMS has had this on the horizon for several years now, the agency has never actually formalized a date when the denials would start. However, a Dec. 13 CMS podcast indicates that CMS "will soon begin denying Part B, DME, and Part A Home Health claims that fail the ordering/referring provider edits." Although CMS notes in the podcast that the agency "does not have a date at this time,"...

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