Centers for Medicare & Medicaid Services May Deny Claims Starting January 6, 2014

There’s important information you need to know if you are an ordering/referring physician for Durable Medical Equipment, Prosthetic, Orthotic and Supplies (DMEPOS) covered by Medicare.

On Jan. 6, 2014, the Centers for Medicare & Medicaid Services (CMS) will turn on the Phase 2 ordering/referring denial edits. This means that Medicare will deny Durable Medical Equipment, Prosthetic, Orthotic and Supplies claims if the ordering/referring physician is not identified, not enrolled in Provider Enrollment, Chain, and Ownership System (PECOS), or not of a specialty type that may order/refer the service/item being billed.

If you have questions or need more information, send an email to the Ohio Optometric Association at info@ooa.org.

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