As audits loom, stick to the rules of advance care planning codes to avoid harm

Why This Topic Matters

Advance care planning claims can be vulnerable in audit if documentation is incomplete or inconsistent. Understanding the scope of CMS guidance helps practices reduce denials, support compliant billing, and align documentation with the service being reported.

Article Sections

1. Audit concerns and documentation examples

   Summarizes the compliance concern that prompted the article and reviews example documentation scenarios discussed in CMS materials. The section focuses on why recordkeeping is relevant to audit review.

2. Review the basic rules

   Introduces the foundational elements used to train staff on advance care planning reporting. It frames the guidance around descriptors, definitions, and diagnosis-related documentation concepts.

3. Delve into the details

   Covers additional operational and documentation considerations raised in CMS guidance, including consent, frequency, reporting context, and coordination with other visits. It also touches on preventive-service billing considerations.

4. Be aware of PHE changes

   Addresses temporary telehealth flexibility discussed in connection with the public health emergency. The section notes the service setting changes described in the article and the time-limited nature of those policies.