Last RAC announces first issues: DCS posts approved issues for Region A
The RAC Report, October 1, 2009
Want to receive articles like this one in your inbox? Subscribe to The RAC Report!
DCS Healthcare has released its first CMS-approved issues for audits in Region A.
The three issues, including one new issue not yet approved in other RAC regions, are applicable to durable medical equipment (DME) suppliers in Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.
According to the DCS Web site, the issues include the following:
- Pharmacy supply and dispensing fees. Pharmacy supply and dispensing fees when billed by a DME supplier are required to be accompanied with an oral anti-cancer, oral anti-emetic, immunosuppressive drug or inhalation drug. The absence of one of the aforementioned drugs billed on the same date of service or a denial of one of the aforementioned drugs represents an overpayment.
- Wheelchair bundling. A potential vulnerability may exist if certain procedure codes are billed in conjunction with other procedure codes for the same date of service and the same beneficiary.
- Urological bundling. A potential vulnerability may exist if certain urological procedure codes are billed in conjunction with other urological procedure codes for the same date of service and same beneficiary.
The DCS Web site also lists several helpful samples and links for providers, including a sample automated review demand letter, a sample complex demand letter, a sample envelope, letterhead, and more.
The RACs from regions B, C, and D have already posted approved issues for most other states. The only states CMS has not yet approved any RAC audit issues for are the Region B states Illinois, Kentucky, Ohio, and Wisconsin.
Editor’s note: For the latest news on CMS-approved issues for DCS and other RACs, visit the Revenue Cycle Institute Web site. (For an updated list of approved issues in your state, visit the “Tools” section of the Revenue Cycle Institute Web site and download the free chart.)
Want to receive articles like this one in your inbox? Subscribe to The RAC Report!
Related Products
-
Billing Alert for Long-Term Care
It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility...
-
2010 RAC Track: Medicare Compliance Forum Audio Recording
On-demand audio recordings of the RAC track of HCPro Revenue Cycle Institute's popular Medicare Compliance Forum, held May...
-
2010 Observation Services Track:
On-demand audio recordings of the Observation Services track of HCPro Revenue Cycle Institute's popular Medicare Compliance...
-
Clinical Documentation Improvement
Hospitals are undoubtedly aware of how a quality clinical documentation improvement program can benefit their facility, but...
-
Medicaid Final Rule for Healthcare-Acquired Conditions
During this 90-minute audio conference, our speakers review the Medicaid HCAC rules and reporting requirements, discuss...
Most Popular
- Articles
-
- HIPAA Q&A: Flu shot requirement for hospital employees
- HealthDataInsights posts new issues for medical necessity claims
- Running an effective peer review committee meeting
- Q&A: Incidental disclosures and patient privacy
- Sneak Peek: Effort underway to establish caseload benchmarks
- New FAQ posted on storing laryngoscope blades
- Tip: Perform your own internal investigation prior to government audit
- What does case-mix index mean to you?
- HIPAA 5010 deadline extended, but threat remains, says AMA
- HHS task force: Consider privacy, security with text messages
- E-mailed
-
- Running an effective peer review committee meeting
- HIPAA Q&A: Flu shot requirement for hospital employees
- What does case-mix index mean to you?
- HHS task force: Consider privacy, security with text messages
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Tip: Correctly code bilateral pain management procedures
- 2012 CPT code changes for ASCs: Shoulder and knee scopes and pain management
- COT basics to best
- Documentation and coding for toxic metabolic encephalopathy
- Guidance and tact key to compliant, effective physician queries
- Searched