Comments for Revenue Cycle Institute

Comment on Region D RAC adds new DME issue by Michael Apolskis

Michael Apolskis — Fri, 20 Nov 2009 18:46:48 +0000

The Senate Democratic health care reform bill provides for the expansion of the Recovery Audit Contractor program. See my Medicare Update post at http://bit.ly/5XFfb7

Comment on 2010 ICD-9 code updates now available online by Deborah Kinnard, RHIA

Deborah Kinnard, RHIA — Mon, 16 Nov 2009 18:23:41 +0000

What is the correct code(s) for pneumonia due to novel H1N1 (confirmed) virus?

Comment on Could RAC mass adjustment changes mean increase in automatic audits? by Matthew C. Kriner

Matthew C. Kriner — Sun, 15 Nov 2009 05:21:29 +0000

yes, absolutely!

Comment on Could RAC mass adjustment changes mean increase in automatic audits? by Matthew C. Kriner

Matthew C. Kriner — Sun, 15 Nov 2009 03:48:54 +0000

Hey very nice blog!! Man .. Beautiful .. Amazing .. I will bookmark your blog and take the feeds also… I am placing a link on my site to yours… what “anchor text” would you like me to use?

Comment on Revenue Cycle Institute releases Observation white paper by Tiffany Walls

Tiffany Walls — Thu, 15 Oct 2009 13:47:23 +0000

Free white paper on Inpatient or Outpatient Only: Why observation has lost its status.

Comment on Q&A: RACs and physician offices by Laurie Dupee

Laurie Dupee — Tue, 01 Sep 2009 17:20:12 +0000

Are nurse practitioners that have a Medicare license being audited under the RACs also?

Comment on Surprise! Voluntary refunds don’t protect against RACs by Twitted by jvbrill

Twitted by jvbrill — Tue, 01 Sep 2009 06:33:57 +0000

[...] This post was Twitted by jvbrill [...]

Comment on RAC Region D News Alert: HealthDataInsights launches new RAC Web site, posts issues eligible for audits by Sherry Nelson

Sherry Nelson — Thu, 27 Aug 2009 11:24:36 +0000

It has always been taught that blood should only be given if a patient is symptomatic and if they get two units. The association over blood(I can’t recall the name) frowns about single units being given. Also with this ruling how about patients in trauma and massive bleeds? You only get paid for one unit per day?

Comment on Surprise! Voluntary refunds don’t protect against RACs by Noemi Rodriguez

Noemi Rodriguez — Wed, 26 Aug 2009 15:39:24 +0000

What is extrapolation?

Comment on Self-examination can help ensure compliance with new CMS-approved audit issues by Mike Hlavac

Mike Hlavac — Fri, 21 Aug 2009 17:00:13 +0000

A patient receives an initial Physical Therapy evaluation as an inpatient. On the same date they are discharged and admitted to SNF where another PT eval. is ordered. Is this considered a 1-time procedure billed twice on the same day?

Comment on Update on Region C RAC Activity: Connolly posts issues for Florida: Issues differ between Region C states by Edward Gross

Edward Gross — Thu, 20 Aug 2009 22:55:12 +0000

Just sent the following e-mail to RAC@cms.hhs.gov and valeria.allen@cms.hhs.gov

I don’t have the time to pursue this but maybe someone at your group might like to. If you can get a definitive response, let me know at Edward.Gross@context4healthcare.com If I get a response, I’ll let you know.

“I would like to point out an inconsistency between the approved RAC IV Hydration audit issue which states that CPT code 96360 (formerly 90760) should have a maximum number of units of 1 while the CMS MUE (Medically Unlikely Edits) value for these same codes is 2.

I’m aware that inquiries regarding MUE (Medically Unlikely Edits) values get mailed/faxed to the National Correct Coding Initiative contractor address; however, I am not questioning this value nor the content/value in this RAC issue. If you feel this is an issue, please feel free to bring it to whomever would be appropriate.”

Comment on RAC Region D News Alert: HealthDataInsights launches new RAC Web site, posts issues eligible for audits by Cam Christensen

Cam Christensen — Thu, 20 Aug 2009 16:42:51 +0000

Why would newborns make the list? How many Medicare pediatric newborns do we have???

Comment on Self-examination can help ensure compliance with new CMS-approved audit issues by Suzonne Bourque

Suzonne Bourque — Thu, 20 Aug 2009 13:50:19 +0000

On the blood transfusion issue, does this only apply to medicare outpatients? Or does it also apply to medicare inpatients?
I know we get a DRG payment in IPs but if wwe are billing more than we should, doesn’t this get applied to the contractual?
Suzonne Bourque

Comment on Self-examination can help ensure compliance with new CMS-approved audit issues by Kathy Sue

Kathy Sue — Thu, 20 Aug 2009 12:36:55 +0000

Do you know where we can find information on the “Once in a lifetime procedures”, “excessive units-Untimed codes: and the “excessive units-IV hydration” these items I have not seen before listed as issues. Thank you for any information regarding these items.

Thank you Kathy Sue

Comment on CMS announces RAC Open Door Forums by revenuecyclemanagement

revenuecyclemanagement — Mon, 17 Aug 2009 14:51:50 +0000

Its nice to hear that cms announces RAC Open Door.To know more about it visit http://www.taurusquest.com

Comment on Surprise! Voluntary refunds don’t protect against RACs by Donald Brown

Donald Brown — Wed, 12 Aug 2009 14:31:46 +0000

My understanding has been if I do an adjusted claim to correct an error, if that claim is reprocessed before the RAC has reviewed it, they can review the claim but the error I had corrected is clean and won’t be subject to takeback. But other errors on the claim would still be subject to takeback.

The RAC process isn’t quite like the OIG audits where they are looking to fine us for errors, corrected or not. They are looking for errors that are still errors.

Comment on Answer and win! What do you know about the RAC Validation Contractor? by Andrea Kraynak, CPC-A

Andrea Kraynak, CPC-A — Tue, 11 Aug 2009 12:45:51 +0000

That’s actually not the correct answer, but if you would like to try again, please e-mail me your response at akraynak@hcpro.com.

Thanks!

Comment on Answer and win! What do you know about the RAC Validation Contractor? by Terri Meehan

Terri Meehan — Tue, 11 Aug 2009 12:31:35 +0000

http://www.cms.hhs.gov/RAC

Comment on RAC Audits to begin in Region C: Connolly posts issues eligible for RAC review by Rachel

Rachel — Thu, 06 Aug 2009 21:57:07 +0000

For the blood transfusions, is it one transfusion charge per SESSION or per DAY? Just had a patient seen in the ED 2x in one day and received transfusions during each separate encounter. This states per session but one of the CMS references states per day.
Has this been clarified?

Comment on Surprise! Voluntary refunds don’t protect against RACs by Andrew Workman

Andrew Workman — Thu, 06 Aug 2009 16:15:50 +0000

I attended the RAC education seminar for NC with Connolly yesterday. Connolly, CMS, and our FI were represented. They said that self-disclosed audits would be off-limits for RAC audits as long as the RAC was aware of them (through submitting the claim information with the refund). They made no mention of providers having to extrapolate self-findings to be exempted from future RAC audits.