By Carol Hoppe, CPC, CCS-P, CPC-I 
MedLucid Solutions, LLC
 
Indiana’s Government Health Administrator, WPS Medicare, notes recent claim reviews performed by the comprehensive error rate testing (CERT) contractor with several error findings for annual wellness visits (AWV). The documentation submitted was missing certain requirements. 

Elements missing in the documentation included: A current list of providers and suppliers who are regularly involved in providing medical care; personalized health advice given to the beneficiary and/or referrals; detection of any cognitive impairment (assessment of individual’s cognitive function by direct observation); screening schedule, such as a checklist for the next five to 10 years, as appropriate; establishment of, or an update to, the individual’s medical/family history; review (and administration if needed) of a health risk assessment; and review of the individual’s functional ability and level of safety.

Learn more
For more on the documentation and billing requirements for these services, see Publication 100-02, Chapter 15, and Medicare Wellness Visits, at www.ismanet.org/MedicareWellnessVisits. WPS Medicare is also hosting a teleconference, “Initial Preventive Physical Examination (IPPE) or Annual Wellness Visit (AWV) Ask-the-Contractor Teleconference (ACT)” on Tuesday, Oct. 12. To register, log in here and select the Catalog link.