E/M Coding Alert - 2011 Issue 8
Part B Payment: One Medicare Contractor OK's RNs and LPNs to Furnish Annual Wellness Visit
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Article Overview
This article is about Medicare Part B operational guidance discussed by CMS, including contractor-level discretion around who may furnish annual wellness visits and how related services are billed, plus CMS’s update on large-volume claim reprocessing tied to Affordable Care Act payment adjustments. It is relevant to providers, billing staff, and compliance teams watching Medicare contractor policy differences and payment correction timelines. The piece also addresses what CMS said practices should and should not do while awaiting automatic claim reprocessing.
Why This Topic Matters
It highlights both service-furnishing policy questions under Medicare Part B and the administrative impact of mass claim corrections, which can affect billing workflow, payment timing, and contractor interactions.
Article Sections
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CMS Open Door Forum guidance on annual wellness visits
Discussion of Medicare Part B questions raised by practices about annual wellness visit operations and contractor-level discretion. The section centers on CMS remarks about how the issue was addressed in the forum.
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Payment adjustments and claim reprocessing
CMS updates on broad claim correction activity linked to Affordable Care Act-related payment changes. The section covers the expected timing and administrative handling of reprocessed claims.
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Claims handling while reprocessing is underway
Guidance about what providers should do while CMS and contractors complete automated adjustments. The section addresses the general processing approach and related payment administration issues.
What You Will Learn
- How CMS discussed Medicare Part B annual wellness visit policy at the contractor level
- What the article says about payment corrections and reprocessing of affected claims
- How the article frames provider responsibilities while waiting for claim adjustments
- Which Medicare administrative bodies are involved in the guidance discussed
Who Should Read This
- Medicare Part B providers
- Billing and reimbursement staff
- Practice managers
- Compliance teams
- Revenue cycle professionals
Codes Discussed
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