Other Issuances: Region C RAC updates issues, OIG reviews oxaliplatin
Medicare Weekly Update, December 29, 2009
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Connolly updates RAC audit issues
On December 24, Connolly Healthcare, the RAC for Region C, updated its list of approved audit issues to include the following:
Medically Unlikely Edit List
A Medically Unlikely Edit (MUE) applies to all HCPCS/CPT codes that are above the maximum units of service that a provider would report for the same beneficiary, on same date of service, and same provider. An error was made in billing these services because more units were billed for a beneficiary than what is medically likely.
View Connolly’s updated list of audit issues.
OIG reviews oxaliplatin
On December 14, the OIG issued a report on outpatient payments for oxaliplatin in Virginia. For all 57 Medicare outpatient payments reviewed, seven hospitals billed National Government Services, a Medicare fiscal intermediary, for the incorrect number of service units of oxaliplatin. This resulted in overpayments totaling $1.4 million during calendar year 2005.
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