Revenue Cycle

RACs not authorized to review all IRF claims

Recovery Auditor Report, March 4, 2010

CMS has notified notified the AHA that RACs have not been authorized to review all inpatient rehabilitation facility claims, according to AHA News Now. Connolly and HDI recently began auditing acute care inpatient hospital claims for two diagnosis-related groups (MS-DRGs 945 and 946) that are used on all IRF claims, prompting concerns that RACs may have CMS authority to review all IRF claims without going through the new approval process. CMS confirmed Friday that RACs may only review IRF claims that have gone through this process. Any IRF that receives a RAC request letter is not required to respond and should contact their CMS RAC project officer.

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