Outpatient Facility Coding Alert - 2014 Issue 25
Physician Notes: CMS Reveals Auditors' Findings Regarding AWVs
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Article Overview
This article reviews CMS-reported audit findings from the Medicare compliance newsletter with a focus on annual wellness visit claims and related billing review themes. It is aimed at physicians, coders, compliance staff, and billing professionals who want to understand the kinds of issues auditors are seeing in Medicare claims and why documentation and claim selection matter. The piece also touches on broader audit observations involving visit coding and payment corrections.
Why This Topic Matters
Understanding common audit findings helps practices recognize areas that may trigger denials, underpayments, or post-payment review activity. It also supports better awareness of Medicare documentation and billing scrutiny.
Article Sections
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CMS audit findings on annual wellness visits
Summarizes the Medicare compliance focus on annual wellness visit claims and the most common claim issues identified through audit activity.
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Documentation and payment review examples
Discusses additional audit observations involving claim review, payment correction, and related Medicare contractor actions.
What You Will Learn
- What kinds of annual wellness visit claim issues CMS highlighted
- How audit findings can affect Medicare payment review
- Why documentation and claim accuracy matter in post-payment audits
- What broader billing patterns may be reviewed by Medicare auditors
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
Codes Discussed
Code Ranges Discussed
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