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HealthDataInsights launches new RAC Web site, posts issues eligible for audits

Patient Access Weekly Advisor, August 19, 2009

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HealthDataInsights, Inc. (HDI), launched its new RAC Web site, and posted the first set of issues eligible for RAC review throughout all 20 RAC Region D states and territories on August 12.  The list of issues will likely be familiar to healthcare providers who saw those announced by Connolly Healthcare earlier this month. HDI has posted the following approved issues:     

• Neulasta (HCPCS code J2505). RACs will review claims submitted with the total number of milligrams instead of one unit per 6mg. Providers should submit claims for J2505 so that the units billed represent the number of multiples of 6mg administered, not the total number of mgs.    
• Newborn Pediatric CPT Codes Billed for Patients Exceeding Age Limit. Certain service codes are specific to patients of a specific age and should not be applied or billed for patients who exceed the age limit defined by the CPT code.    
• Once in a Lifetime. Certain procedures are only performed once in a person’s lifetime. RACs will seek to identify claims paid for those procedures for more than one service date.    
• Excessive Units—Untimed Codes. When reporting service units for untimed codes (excluding modifiers -KX and -59) where the procedure is not defined by a specific time frame, the provider should enter a “1” in the units bill column per date of service.    
• Excessive Units—Blood Transfusions. Providers should bill blood transfusions with a maximum of one unit per patient per date of service.   
• Excessive Units—Bronchoscopy. Providers should bill bronchoscopy services with a maximum number of one unit per patient per date of service.    
• Excessive Units—IV Hydration. Providers should bill IV hydration with a maximum number of one unit per patient per date of service.

Read the full story on the Revenue Cycle Institute Web site.

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