Recent RAC Activity
Recovery Auditor Report, April 15, 2010
CGI adds two new issues for medically unlikely edits (outpatient and professional)
CGI, the RAC for Region B, added medically unlikely edits for outpatient and professional claims review to its CMS-approved list for providers in all Region B states.
View the new issues by visiting the CGI Web site.
HDI removes existing issue
HealthDataInsights, the RAC for Region D, has removed a RAC issue for all Region D states. The removed issue is Anesthesia care package E/M services.
In addition, HDI has revised the description for an existing RAC issue for all Region B states. The updated issue is as follows:
Acute hospital readmissions without condition code B4 or 42.
- Previous description: An improper payment occurs when two separate acute hospital claims are paid for a Medicare beneficiary who is discharged and re-admitted on the same day and for the same DRG and there is no B4 condition code on the second claim
- New description: An improper payment occurs when two separate acute hospital claims are paid for a Medicare beneficiary who is discharged and re-admitted on the same day and for the same DRG and there are no B4 or 42 condition codes on the second claim.
Stay on top of these issues by visiting the HDI Web Site.
Related Products
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Complications from immobility by body system
- Nursing responsibilities for managing pain
- Q&A: Primary, principal, and secondary diagnoses
- The consequences of an incomplete medical record
- Note similarities and differences between HCPCS, CPT® codes
- Neurological checks for head injuries
- Practice the six rights of medication administration
- Skills of effective case managers
- 10 Tips for Educating Elderly Patients
- E-mailed
- Searched