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A claim submitted with K50.90 (Crohns disease, unspecified, without complications) when the chart documents fistula or abscess will fail clinical validation audits

During the recalculation period CMS would also identify whether the relevant performance year is also serving as a benchmark year for the ( ACO's current agreement period and prepare to adjust the ACO's benchmark year expenditures to account for the revised initial determination (once issued), as discussed in section III.G.7.c.(2).(d) of the CY 2025 PFS proposed rule (89 FR 61907)

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