CMS Will Enforce Integrity Requirement Using Claims Edits

CMS will implement claims edits to enforce a 2010 requirement that certain Medicare claims for home health, Part B laboratory and imaging services, and durable medical equipment identify the ordering or referring physician, according to an AHA News Now report.  

Effective May 1, CMS will require that for a claim to be paid, the listed ordering or referring physician must be currently enrolled in Medicare and eligible to order or refer the service or item being billed.

More Articles on CMS:

CMS: Hospital Readmissions Down to 17.8%
CMS Touts Lower Healthcare Spending, Readmissions Under PPACA
CMS Releases FAQs on Medicaid RACs


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