Automatic Accreditation Edits

BALTIMORE — CMS has issued MLN Matters MM7073 on
licensing, accreditation and other mandatory quality
requirements.

According to the article: “Edits for the Healthcare Common
Procedure Coding System (HCPCS) codes in the product categories
designated by MIPPA as requiring accreditation will be in effect.
Effective for claims with dates of service on or after July 5,
2011, this Medicare systems edit will automatically deny claims for
these codes unless: 1. The DMEPOS supplier has been identified as
accredited for the timeframe that covers the date of service on the
claim; or 2. The DMEPOS supplier is currently exempt from meeting
the accreditation requirements.”

View a PDF of the full MLN Matters MM7073 article.