tci Part B Insider - 2012 Issue 3

Physician Note: Check Out What Your RACs Are Reviewing These Days

Plus: CMS clarifies 5010 advice.When the Recovery Audit Contractor (RAC) system first began, providers stayed very well-connected to the review issues, but as time passed, some practices stopped paying attention. However, RACs continue to add new issues to their target lists, and it's incumbent upon you to keep track of the issues at hand.For example: DCS Healthcare, the RAC for seven states in the Northeast, announced on Jan. 6 that it is reviewing overpayments made for E/M services billed without modifier 25 on the same date as allergy testing or allergen immunotherapy. "Claims having a 'claim paid...

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