Revenue Cycle

HealthDataInsights posts new RAC issue for Part B claims

Recovery Auditor Report, December 10, 2009

HealthDataInsights (HDI) has added a new RAC issues to its CMS-approved list earlier this month for providers in all Region D states.
According to the HDI Web site, the new issue pertains to Part B claims. Its description is as follows:
  • Facility vs. nonfacility reimbursement (inpatient). Under the physician fee schedule, some procedures have a separate Medicare fee schedule for a physician’s professional services when provided in a facility and a nonfacility. CMS furnishes both fees in the MPFSDB update. Professional fees, when the services are provided in a facility, are applicable to procedures furnished in the facilities.
To stay on top of the latest RAC-approved issues in your state, visit the “Tools” section of the Revenue Cycle Institute Web site and download the updated chart at the top of the page.

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