Revenue Cycle

Update: New issues approved for Florida

Recovery Auditor Report, September 3, 2009

Editor’s note: This updates the information on Florida RAC issues included in the last issue of The RAC Report. For the latest RAC updates, keep your eye on the Revenue Cycle Institute blog at
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 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 transfusion
  7. Urological bundling
  8. Wheelchair bundling

Note that CMS has not approved bronchoscopy services audits 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.
At the time of publication Connolly has not yet posted approved issues for several states and territories in the region, including Arkansas, Louisiana, Mississippi, North Carolina, New Mexico, Oklahoma, Tennessee, Texas, and West Virginia, as well as Puerto Rico and the U.S. Virgin Islands.

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