Lori Brocato is currently HealthPort's RCM and RACPro Product Manager and serves as our resident expert on the Recovery Audit Contractor (RAC) program. In 2009 Lori served as a monthly co-contributor in Advance Magazine for Health Information Professionals' e-newsletter, RAC ready column, that served as a "monthly RAC survival guide."
With posts to the RAC blog, HealthPort helps hospitals plan for, track and deal with RAC audits. We are committed to your success under Medicare's RAC program. Check this page often for the latest news, education and free Webinars about RAC.
Connolly Healthcare Posted the First Set of Issues Eligible for RAC Review
Connolly Healthcare, the RAC for Region C, has posted the first set of issues eligible for RAC Review on its Website.
- Blood transfusions. Description: CPT codes 36430, 36440, 36450, and 36455 (excluding claims with any modifiers) as one per session, regardless of the number of units transfused on that date of service.
- Untimed codes. Description: CPT codes, excluding modifiers -KX and -59, where the procedure is not defined by a specific time frame (i.e., untimed codes). The provider should enter a one(1) in the units billed column per date of service.
- IV hydration therapy. Description: Based on the definition CPT code 90760, the maximum number of units should be one per patient per date of service (excluding claims with modifier -59).
Note: Beginning January 1, 2009, code 96360 replaced code 90760.
- Bronchoscopy services. Description: CPT codes 31625, 31628, and 31629 should be billed with a maximum number of units of one per patient per date of service (excluding claims with modifier -59).
- Once-in-a-lifetime procedures. Description: By virtue of the description of the CPT code, providers may only perform these codes once per patient lifetime.
- Pediatric codes exceeding age parameters. Description: Newborn and pediatric CPT codes billed or applied to patients who exceed the age limit defined by the CPT code.
- J2505 (Injection, Pegfilgrastim, 6 mg). Description: By definition, HCPCS code J2505 represents 6 mg per unit. Providers should bill the code at one unit per patient per date of service.
Click Here for more detailed information.
Not sure what region you are in?
Click here to view the map
Post comments.
|
Return to top.
|