ED Coding & Reimbursement Alert - 2012 Issue 21
Audits: CMS Eliminates 12-Month Claim 'Lookback' Period
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Article Overview
This article covers a CMS program integrity update that changes the documentation lookback timeframe used in Medicare Part B audit activity. It is relevant to practices, compliance staff, and coding/billing teams that manage medical record retention and respond to contractor record requests. The discussion focuses on the policy change, its effective date, and the operational implications for recordkeeping expectations.
Why This Topic Matters
The change may affect how practices store, retrieve, and produce documentation during Medicare audits. Understanding the update helps organizations prepare for record requests that may reach further back than the prior routine timeframe.
What You Will Learn
- How a CMS transmittal changes Medicare audit documentation request timing
- How the update affects expectations for medical record retention and retrieval
- Why state record-retention requirements may still matter for practice operations
- What Medicare Part B practices should know about contractor record requests
Who Should Read This
- Medical coders
- Coding auditors
- Compliance staff
- Practice administrators
- Revenue cycle teams
- Healthcare providers
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