RAC Audits: Brace For Intensified Scrutiny

Why This Topic Matters

Audit priorities can affect claim denials, repayment risk, and documentation expectations. Readers can use this article to gauge whether their workflows, diagnosis support, and billing practices may be under increased scrutiny.

Article Sections

1. Mohs Surgery

   Discusses RAC review activity involving Mohs surgery claims and the documentation themes associated with this audit focus.

2. Cataract Extraction

   Covers audit attention on cataract surgery claims and the relationship between procedure review and Medicare coverage policies.

3. Transthoracic Echocardiography

   Summarizes audit activity related to transthoracic echocardiography and the use of diagnosis-code-based medical necessity screening.

4. Ultrasound Guidance

   Describes audit review of ultrasound guidance claims with emphasis on claim-volume concerns and edit-based oversight.