Region D Medicare Recovery Audit Contractor Posts New CMS Approved Audit Issues
HealthDataInsights, Inc. (HDI), the Medicare recovery audit contractor (RAC) for Region D, recently posted new CMS approved audit issues for RAC review on its website. Specifically, HDI added the following new CMS approved audit issues : Medical Supplies and Home Health Consolidated Billing Date of Death – DME The above issues apply to all states within Region D. See the HDI website for more details regarding the new CMS approved audit issues . Region D includes Alaska, Arizona, California, Hawaii, Iowa, Idaho, Kansas, Missouri, Montana, North Dakota, Nebraska, Nevada, Oregon, South Dakota, Utah, Washington, Wyoming
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CGI , the Medicare recovery audit contractor (RAC) for Region B , recently added new CMS approved audit issues for RAC review. With respect to the claims of outpatient hospitals and physicians, CGI posted a new CMS approved audit issue titled ” Medical Unlikely Edit (MUEs) ,” which applies to all states within Region B. However, CGI...
CGI , the Medicare recovery audit contractor (RAC) for Region B , recently added new CMS approved audit issues for RAC review pertaining to inpatient claims and MS-DRG validation. According to the CGI website, the new issues include: Liver Transplant DRG 480 MS-DRG 006 Post Operative Anemia MS-DRG 467, 481, 486, 488 The above issues apply to all...
DCS Healthcare (DCS), the Medicare recovery audit contractor (RAC) for Region A, recently posted 3 new CMS approved audit issues for RAC review on its website. Specifically, DCS posted the following issues pertaining to inpatient hospitals and DRG validation: MS-DRG Validation for MS-DRGs with Ventilator Support of 96+ hours MS-DRG Validation for...
Connolly Healthcare , the Medicare recovery audit contractor (RAC) for Region C, recently updated its CMS approved audit issues for RAC review. Specifically, Connolly Healthcare recently posted at least 19 new CMS approved audit issues on its website for inpatient hospitals pertaining to DRG validation. The issues affect providers in the states...
DCS Healthcare (DCS), the Medicare recovery audit contractor (RAC) for Region A, recently posted a new CMS approved audit issue for RAC review on its website pertaining to DME suppliers. According to the DCS website, the issue is titled “Oxygen Accessories” and it applies to all states within Region A. Region A includes Connecticut,...
CGI , the Medicare recovery audit contractor (RAC) for Region B , recently added new CMS approved audit issues for RAC review. Specifically, it appears that CGI added a number of new CMS approved audit issues pertaining to inpatient claims and MS-DRG validation for all states within Region B. In brief, those issues appear to include: Acute Respiratory...
HealthDataInsights, Inc. (HDI), the Medicare recovery audit contractor (RAC) for Region D, recently posted new CMS approved audit issues for RAC review pertaining to Part A inpatient claims and DRG validation. According to the HDI website, the issues include: Breast Procedures Cardiovascular (Other) Nose, Mouth & Throat Disorders Endocrine,...
HealthDataInsights, Inc. (HDI), the Medicare recovery audit contractor (RAC) for Region D, recently posted a new CMS approved audit issue for RAC review pertaining to inpatient claims and DRG validation. According to the HDI website, the issue is titled “DRG Validation-Pregnancy, Childbirth & Peruperium” and it applies to all states...
Below are the top ten Medicare Update posts during January 2010 (based on the number of views): 1) CMS Proposes Meaningful Use Definition and Standards for Electronic Health Record Incentives Program 2) DOJ/HHS to Hold National Summit on Health Care Fraud 3) New Requirements Cause Thousands of DMEPOS Suppliers to Exit Medicare Program...
On March 17, 2010, the Centers for Medicare & Medicaid Services (CMS) posted a new Frequently Asked Question (FAQ) on the Medicare Recovery Audit Contractor (RAC) Program . The new FAQ addresses the RAC discussion period and the rebuttal and redetermination process. The new FAQ and related link is set forth below: What is the difference between...
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