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  2. CQM-6643

CMS139 v12: Reason for why G0402 is not a qualifying encounter

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    • Resolution: Answered
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    • John Carlo
    • Signify Health
    • Thank you for your inquiry for CMS139v12: Falls: Screening for Future Fall Risk. We will review this code and any changes will be included in a future release.
    • CMS0139v12
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      Initial Preventive Physical Examination or "Welcome to Medicare" (G0402) is a visit type offered to newly enrolled Medicare beneficiaries. Per CMS standards, screening for a fall risk is a mandatory component of the visit, so any patients that has this encounter code will not be included in the Initial Population data element of the measure.
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      Initial Preventive Physical Examination or "Welcome to Medicare" (G0402) is a visit type offered to newly enrolled Medicare beneficiaries. Per CMS standards, screening for a fall risk is a mandatory component of the visit, so any patients that has this encounter code will not be included in the Initial Population data element of the measure.

      Is there a specific reason why G0402 or the IPPE/"Welcome to Medicare" encounter is not a qualifying encounte for CMS139 v12? Since screening for future fall risk is a mandatory requirement to complete this visit, I am not sure why this encounter code will be excluded?

            edave Mathematica EC eCQM Team
            joluna John Carlo
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