Reminder from CMS

The Centers for Medicare and Medicaid Services (CMS) will instruct contractors to turn on Phase 2 denial edits on January 6, 2014.  These edits will check the following claims for a valid individual National Provider Identifier (NPI) and deny the claim when this information is invalid:


  • Claims from clinical laboratories for ordered tests;
  • Claims from imaging center for ordered imaging procedures; and
  • Claims from suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) for ordered DMEPOS.