RADV Audit Schedule 2026: What Teams Should Do Before Charts Are Pulled

Quick Answer

RADV preparation should start before charts are pulled. The best use of prep time is to find diagnoses that map to HCCs but lack current MEAT or source-of-evidence support. Teams should review high-risk HCCs, problem-list-only diagnoses, unsupported recaptures, and documentation gaps before the request arrives.

CMS maintains RADV program materials and schedule information on its RADV documents page. Coding teams should use the CMS materials for program status and use internal QA to reduce unsupported diagnosis risk before audit activity reaches the chart-pull stage.

Source: CMS RADV documents and data.

What To Review Before Charts Are Pulled

Start with diagnoses that have the highest chance of failing support review:

1. Conditions copied forward from a problem list.

2. Chronic conditions mentioned without assessment or treatment.

3. HCCs captured from medication context alone.

4. Diagnoses where specificity was coded but not documented.

5. Recaptured conditions with no current-year MEAT.

The goal is not to remove valid codes. The goal is to separate supported diagnoses from diagnoses that need clarification, additional documentation review, or conservative handling.

Common RADV Failure Patterns

The most common failures are not exotic. They are ordinary documentation problems repeated at scale:

Use the MEAT criteria guide to review documentation support and use the evidence checker when you need a structured way to evaluate support language.

How HCC Buddy Fits The Workflow

HCC Buddy is useful before chart pulls because it keeps the key decision points together:

For example, if a coder reviews E11.65, the mapping matters, but support still matters more. Diabetes with hyperglycemia must be documented and supported in the encounter. A mapped HCC without support is an audit risk, not a win.

Chart-Pull Prep Checklist

Before charts are requested, teams should:

1. Identify the highest-value HCCs in the sample period.

2. Compare mapped conditions against current-year MEAT.

3. Flag problem-list-only captures.

4. Check whether provider language supports code specificity.

5. Route unclear cases for manager review before audit submission pressure starts.

For a printable internal reference, use the 2026 RADV, MEAT, and SOE Checklist.

Bottom Line

RADV readiness is not only a retrieval process. It is a support review process. The earlier a team separates supported, needs-review, and unsupported diagnoses, the less likely it is to defend weak captures after the clock starts.