Wiki 1100F-Fall risk assessment

[mwells2020]

Hello! I am just needing feedback on if anyone uses this 1100F code on Medicare wellness exams? If so, do you get reimbursed or is it just for data mining?

 

[thomas7331]

Codes in this category are for reporting quality measures - they aren't fee-for-service codes and aren't reimbursed on individual claims. However reporting these codes does have a financial impact on the practice because failure to fully participate in quality reporting may result in a penalty on future Medicare payments. So these are not 'just for data mining' - they do play a role in reimbursement in the long run.

 

[mwells2020]

Does this code go in on the claim? Is there a "G" code for Medicare?

 

[thomas7331]

Does this code go in on the claim? Is there a "G" code for Medicare?

I'm not an expert on quality reporting - really this is something on which your manager should be directing you because it involves decisions at the practice level about how and whether or not your organization chooses to participate and how you will report the measures. It's something that someone in your practice will probably need to have specialized training for in order to do it correctly.

There is no substitute "G" code for something like this. Again, the codes in this category are not for reporting payable services performed, they are for patient quality measures that your physician is recording and reporting to CMS.

 

[njycarter17]

Hello! I am just needing feedback on if anyone uses this 1100F code on Medicare wellness exams? If so, do you get reimbursed or is it just for data mining?

Yes this for reporting quality performance measures - 1100F is used to report for patients that are 65 yrs old and older.

 

[njycarter17]

Does this code go in on the claim? Is there a "G" code for Medicare?

Yes it goes on the claim as long as the falls risk assessment was completed