decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 10 (October)
Urology RoundUp: Urology cath and supply A-codes targeted by Medicare RAC
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Article Overview
This article covers a Medicare Recovery Audit Contractor review initiative affecting urology practices, with emphasis on bundled reporting issues for urological catheter supply claims under a Medicare Advantage policy. It is relevant to urology billers, coders, compliance staff, and practice managers who monitor audit activity, policy changes, and supply-code billing relationships. The article also points readers to official resources for the RAC target list and the referenced policy.
Why This Topic Matters
Urology practices that bill catheter-related supplies need to understand the audit focus and the policy basis behind it so they can assess exposure, review claims history, and monitor compliance efforts.
Article Sections
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Audit focus and affected practices
Introduces the Medicare audit initiative, the population of urology practices that may be affected, and the general reason these claims are being reviewed.
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Bundling edits from the Medicare Advantage policy
Summarizes the policy-based bundling relationships discussed in the article and how the audit relates to those claim combinations.
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Official resources
Provides references to external sources for the RAC target list and the related Medicare Advantage policy.
What You Will Learn
- The general purpose of the audit initiative affecting urology supply claims
- The types of policy-based billing relationships being reviewed
- Where to find official external references related to the audit
- Which organizations are involved in the audit activity
Who Should Read This
- Urology coders
- Medical billers
- Compliance staff
- Practice managers
- Revenue cycle professionals
Codes Discussed
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