Revenue Cycle

Connolly posts issues for review in Florida: Issues differ between Region C states

Recovery Auditor Report, August 20, 2009

Connolly Healthcare, the RAC for region C, has now posted issues for review in Florida, including one issue not yet approved for other locations.

Similar to South Carolina, RACs may now audit providers in Florida on the following six issues:

  1. Untimed codes
  2. IV hydration therapy
  3. Once in a lifetime procedures
  4. Pediatric codes exceeding age parameters
  5. J2505: Injection, Pegfilgrastim, 6 mg
  6. Blood transfusions

Note that CMS has not approved bronchoscopy services at this time for Florida providers.

However, CMS has approved the following new issue:

  • Clinical social worker (CSW) services. CSW services rendered during an inpatient hospital stay are not separately payable under Medicare Part B; they are included in the facility’s prospective payment system (PPS) payment. CSW providers are expected to seek reimbursement from the facility.

Connolly has not yet posted approved issues for other states and territories in the region, including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, New Mexico, Oklahoma, Tennessee, Texas, West Virginia, as well as Puerto Rico and the U.S. Virgin Islands.

Visit the Revenue Cycle Institute blog for daily updates on CMS-approved issues and other RAC news.

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