E/M Coding Alert - 2012 Issue 3
Physician Note: Check Out What Your RACs Are Reviewing These Days
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Article Overview
This article summarizes recent Recovery Audit Contractor (RAC) review targets affecting physician billing and claims payment review, along with a note about CMS clarification related to 5010 advice. It is intended for coding, billing, and compliance staff who monitor audit trends and want a high-level view of the kinds of issues being reviewed across multiple regions. The piece discusses the general subject areas under review without replacing the underlying premium guidance.
Why This Topic Matters
Understanding current RAC review focus helps practices stay aware of audit risk areas and monitor compliance activities across evaluation and management, surgery, chemotherapy administration, and other claim types.
What You Will Learn
- How RAC activity can affect physician billing oversight
- Which broad claim areas are being reviewed by different RACs
- What kinds of compliance topics are highlighted alongside CMS clarification notes
- Why monitoring audit trends matters for coding and billing teams
Who Should Read This
- Physician coders
- Billing staff
- Compliance officers
- Practice managers
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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