Corporate Compliance

Other Issuances: Region D RAC updates audit issue description

Medicare Insider, April 13, 2010

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HDI updates audit issue

Health Data Insights, the Region D RAC, has updated its description of an existing audit issue as follows:

Acute hospital readmissions without condition code B4 or 42

Previous description:  An improper payment occurs when two separate acute hospital claims are paid for a Medicare beneficiary who is discharged and re-admitted on the same day and for the same DRG and there is no B4 condition code on the second claim

New description: An improper payment occurs when two separate acute hospital claims are paid for a Medicare beneficiary who is discharged and re-admitted on the same day and for the same DRG and there are no B4 or 42 condition codes on the second claim.

View HDI’s updated audit issues list.



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