The Centers for Medicare & Medicaid Services (CMS) would like to inform the provider community about a recent update related to transplant program data and claims processing. Change Request (CR) 14262 was implemented to improve data accuracy between the Provider Enrollment, Chain and Ownership System (PECOS) and the Fiscal Intermediary Shared System (FISS). The goal of this effort is to ensure that transplant program organ type information is consistent across both systems, helping reduce claim processing issues and improve overall data integrity.

As part of this change, transplant program information from the Quality, Certification and Oversight Reports (QCOR) system was loaded into PECOS. However, it has been brought to our attention that providers associated with the Heart Assist Registry (HAR) organ type were not included in this data load. As a result, some claims have been returned to providers (RTP), creating unnecessary delays and administrative burden.

To address this issue and prevent further claim disruptions, Medicare Administrative Contractors (MACs) will manually update PECOS to include the HAR organ type for all applicable providers. These updates will be based on the list of approved facilities available on the CMS Ventricular Assist Devices (VAD) webpage.

If MACs identify additional providers that are certified with the HAR organ type but are not listed, they will follow the same manual process to ensure those providers are accurately recorded in PECOS. This action is critical to ensure claims process correctly and without delay.