Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DMEPOS, and Part A Home Health Agency Claims

Wednesday, March 20, 2013
3:00 PM - 4:00 PM Eastern Time

Registration is no longer available for this event.

CMS will hold a National Provider Call on March 20 from 3-4:00 ET on the “Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DMEPOS, and Part A Home Health Agency Claims.” Effective May 1, 2013, CMS will instruct contractors to turn on Phase 2 denial edits on the following claims to check for a valid individual National Provider Identifier (NPI) and to deny the claim when this information is missing

Medicare Part B laboratory and imaging claims and Durable Medical Equipment, Orthotics, and Supplies (DMEPOS) claims that require an ordering or referring physician/non-physician provider; and
Part A Home Health Agency (HHA) claims that require an attending physician provider.
Provider Types Eligible to Order/Refer
Action Steps for Billing Providers
Action Steps for Providers Who Order/Refer

Target Audience
Part B providers which order, refer and/or bill for these services; Home Health Agencies

The presentation for this call will be posted at least one day in advance of the call on the FFS National Provider Calls web page. In addition, the link to the slide presentation will be emailed to all registrants on the day of the call.

Registration will close at 12:00 p.m. ET on the day of the call or when available space has been filled.

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Continuing Education Credits Notification
Continuing education credits may be awarded by some professional organizations for participation in CMS National Provider Conference Calls. If you plan to request continuing education credit from your professional organization and if this organization requires proof of registration, you will personally need to register so that you receive a confirmation e-mail. For more information on continuing education credits for participating in CMS National Provider Calls, please visit If you have specific questions concerning continuing education credits, please contact your organization, not CMS.

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