Happy May Day! CMS is delaying implementation of phase 2 PECOS edits

CMS has announced that, due to technical issues, implementation of the phase 2 ordering and referring denial edits is being delayed. These edits would have checked claims for approved or validly opted out physician or non-physician who is an eligible specialty type with a valid National Provider Identifier (NPI). If either of these were missing or incorrect, claims would deny. This would include Home Health Agency claims that require an attending physician provider.

CMS will release the new implementation date in the near future. In the meantime, informational messages will continue to be sent for those claims that would have been denied had the edits been in place.

For more information go to the CMS website.

Until next time,


Up ↑

%d bloggers like this: