Other Issuances: RACs update audit issues, OIG audits lab billing, and more
Medicare Insider, March 30, 2010
Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!
RACs update audit issues, post demand letter
CGI Federal and HealthDataInsights, the RACs for regions B and D, continue to update their approved audit issues. CGI has also posted a sample of its demand letter for complex issues.
View CGI's complex demand letter.
HHS posts appeals decision
HHS has released an appeals decision related to recoupment of reimbursement for medically unnecessary inpatient stays. Because Part B payment can be made in cases when Part A payment is denied, the Medicare Appeals Council directed the contractor to work with the provider to take whatever actions are necessary to arrange for billing under Part B, and thus offset any Part A overpayment.
OIG audits separately billed lab tests for ESRD beneficiaries
On March 18, the OIG released an audit report on separately billed laboratory tests submitted by Spectra Laboratories for Medicare beneficiaries with end-stage renal disease (ESRD) receiving dialysis at Fresenius Medical Care North America’s facilities. The OIG determined that Medicare overpaid Spectra $5.4 million for separately billed laboratory tests from 2004–2006.
Frequently asked questions
CMS has posted several new/updated frequently asked questions (FAQ).
Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!
Related Products
-
Prevent Denials and Win Appeals:
Hospital case managers and directors of case management will find Prevent Denials and Win Appeals to be a valuable partner...
-
Mastering the Three-Day Payment Window
During this 90 minute audio conference our expert speaker, Kimberly Anderwood Hoy provides a brief history of the rule...
-
Acute and Chronic Renal Failure Coding:
Our experts address new AKIN criteria, acute vs. chronic kidney disease, and other clinical aspects of renal failure and...
-
Optimizing PEPPER in the Audit Environment
Our experts cover changes to PEPPER, as well as provide advanced techniques and strategies for incorporating the data into a...
-
Revenue Cycle Digital Library - Reimbursement - Single User Access
A searchable, Web-based resource that provides online access to HCPro’s expertly developed Medicare reimbursement books and...
Most Popular
- Articles
-
- CMS seeks comment on quality measures
- Don't forget the three checks in medication administration
- Practice the six rights of medication administration
- Note similarities and differences between HCPCS, CPT® codes
- What to include on the incident report
- Q&A: Primary, principal, and secondary diagnoses
- Code diagnoses and outpatient treatment for PTSD
- Understanding nursing roles in quality improvement
- OB services: Coding inside and outside of the package
- Complications from immobility by body system
- E-mailed
-
- Patient care orders/protocols: What do the regulations say?
- Tip of the week: Verify that workers know how to clean IV pumps
- The five key elements of a good orientation program
- Q&A: Code assignment for hospital acquired/healthcare associated conditions
- CMS final rule clarifies that medical staff can extend beyond physicians
- Searched
