Revenue Cycle

CMS changes RAC medical record request limits for DRG validation audits

Recovery Auditor Report, December 10, 2009

CMS has published new documentation request limits for RAC DRG validation audits in 2010.
 
CMS changed the limits to a maximum of 200 record requests per campus (not NPI) per 45-day period–at least through March 2010. Beginning in April providers or suppliers who bill in excess of 100,000 claims to Medicare may receive up to 300 requests per campus. 
 
In addition, CMS will allow the RACs to request permission on a case-by-case basis to exceed the cap beginning in July 2010. 
 
For more information on other changes, visit the CMS RAC Web site.

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