decisionhealth Newsletters, Part B News - 2009 Issue 7 (July)
CMS: RACs are free to target E/M services for medical necessity errors
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Article Overview
This article explains CMS guidance and commentary on how recovery audit contractors may review physician evaluation and management services during the permanent RAC program. It is relevant to compliance, auditing, and billing professionals who need to understand the scope of RAC review activity and the general policy context discussed by CMS.
Why This Topic Matters
It clarifies the reported CMS position on RAC audit scope for physician services, which can affect documentation review, compliance monitoring, and preparation for contractor audits.
What You Will Learn
- The CMS position discussed regarding RAC review scope for physician services.
- How the article frames audit activity related to medical necessity concerns.
- The broader compliance and auditing context surrounding E/M service review.
- The type of CMS source material referenced in the news item.
Who Should Read This
- Medical coders
- Biller/collectors
- Compliance officers
- Revenue cycle professionals
- Physician practice managers
- Auditors
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