tci Medicare Compliance & Reimbursement - 2020 Issue Q1

Recovery Audit Contractors: Expect Heightened Scrutiny on AWV and IPPE Blunders in 2020

All 3 RACs spotlight this perennial Medicare problem. Annual wellness visits (AWVs) and initial preventive physical exams (IPPEs) 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 or inaccurate medical records and confusion over Medicare’s policies. That’s why AWVs and IPPEs are back on the recovery audit contractors’ (RACs’) radar. Background: It’s easy to mix up Medicare’s coverage rules for IPPEs and AWVs — and apparently many providers are doing just...

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