Friday, April 26, 2024

PECOS Issue

Dean Mason

Dear Colleagues:

The questions that now need be asked to CMS is should a claim be denied
because a physician is not enrolled in PECOS, who is responsible for payment
for the device? Will it be considered non-covered? Do we need an ABN to
cover the physician ‘s non-registration? Can the claims be resubmitted once
the registration is complete?

I called several of my physicians yesterday to inform them of this change.
It appears that it has come out of nowhere as I do not recall any advance
warning on this forum or from the emails received from my DMEMAC. The doc’s
office called their billing service who informed them that they did not have
to worry about it. I don’t know if the service already submitted for the
physician or that the billing service does not think that the physician
needs to be concerned about this registry.

The fact that we will not be able to verify that a licensed physician can
write scripts for DME is an outrage. The physicians have nothing to lose
and we have everything to lose.

Dean Mason, C. Ped, BOCO, CO

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