tci Part B Insider - 2017 Issue 6

RAC Audits: Focus on AWV Basics or Risk Your Claims Coming Under Review

Don’t confuse a “Welcome to Medicare” visit with an annual wellness visit. Annual wellness visits are a continual source of confusion for both patients and providers. Even after questions are asked and files are checked, mistakes are often made, mostly due to a combination of lapsed records, confusion, and CMS minutia. That’s why annual wellness visits are back on the RACs radar. Problem: Performant Recovery, the Recovery Audit Contractor (RAC) for jurisdictions one and five, recently updated that it will be focusing on claims that abuse the one-time-only code HCPCS G0438 (Annual wellness visit; includes a...

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