Other Issuances: RAC issues audit update, CMS clarifies anesthesia guidelines, and more
Medicare Weekly Update, December 22, 2009
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Region D RAC posts new issues
On December 18, HealthDataInsights, the RAC for Region D, posted three new issues approved for auditing by CMS:
- SNF consolidated billing
- A4221 excessive units
- Prosthetic bundling
CMS clarifies anesthesia guidelines
On December 11, CMS issued a memorandum to clarify the interpretive guidelines for anesthesia services under the hospital conditions of participation.
OIG audits high-dollar claims
The OIG issued two reports on high-dollar inpatient and outpatient claims processed by Trailblazer and Cahaba GBA. The OIG identified a total of $2.6 million in overpayments made by the two contractors.
View the OIG report on high-dollar outpatient claims.
View the OIG report on high-dollar inpatient claims.
OIG audits oxaliplatin billing
On November 30, the OIG issued a review of oxaliplatin billing at Saint Vincent Infirmary Medical Center for calendar year 2005. Saint Vincent billed for 10 times the number of units of oxaliplatin than were actually administered and received overpayments totaling $15,000.
Frequently asked questions
CMS posted several new/updated frequently asked questions (FAQ).
View a listing of recent FAQs.
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