decisionhealth Newsletters, Part B News - 2011 Issue 1 (January)
CMS: Some wellness visits were incorrectly denied, but contractors will reprocess claims
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Article Overview
This article explains a CMS notification about claim-processing errors that led to incorrect denials for annual wellness visit services at a few Medicare Administrative Contractors. It is relevant to billing and coding staff who submit Medicare claims and monitor contractor-specific updates, because CMS indicates affected claims will be reprocessed and provider guidance may come from individual contractors.
Why This Topic Matters
It helps practices understand whether denial activity may be related to a contractor-specific issue rather than a broader national policy change, and it highlights the need to watch for contractor communications and claim reprocessing activity.
What You Will Learn
- What CMS said about the cause and scope of the claim denials
- How affected Medicare contractors were responding
- What providers were told to watch for regarding claim reprocessing and contractor outreach
- How the issue may affect billing workflow for annual wellness visit claims
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle personnel
- Practice managers
- Medicare-participating providers
Codes Discussed
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