Designed to enlighten and enthrall
Can you get the right answer?
How often are Medicare Advantage diagnostic risk codes reset back to zero?
A. one month
B. six months
C. one year
D. two years
E. they are never reset, once a diagnostic risk code is sent to CMS, it’s there permanently.
Answer: C one year.
That’s why it’s so important to see every patient on your panel every year for a comprehensive visit to ensure their diagnostic codes are collected and submitted. If you don’t, the government will pay you for the next year based on the assumption that they have no chronic diseases—and the financial risk for those chronic illnesses will fall on your shoulders rather than the government’s.
In a huge change, that one-year time frame will soon be extended to two calendar years instead of one—more on that later