Health Information Management

Target these RAC focus areas

HIM-HIPAA Insider, December 23, 2008

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Kathy M. Johnson, RHIA, director of coding services at Care Communications in Chicago, says the RAC demonstration project revealed several target areas. She advises HIM directors to focus on these target areas before and during the permanent program. These areas include but are not limited to: 

  • Medical back pain
  • Respiratory failure
  • Lack of medical necessity related to one-day stays
  • Observation cases
  • Infusions
  • Lack of medical necessity related to three-day stays at an acute care hospital prior to being admitted to a skilled nursing facility
  • Lack of medical necessity related to outpatient physical and speech therapy
  • Duplicate charges (e.g., codes that HIM staff members assign that are also assigned by the chargemaster, such as multiple colonoscopies billed for the same patient on the same day)

Editor’s note: This tip was excerpted from the January issue of Medical Records Briefing. For more information, click here.



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