tci Part B Insider - 2014 Issue 8

Recovery Audit Contractors: This RAC Targets 'Excessive' Hospital Visits

Plus: Angioplasty will be targeted for review effective immediately. Your doctor sees an inpatient in the morning and bills an initial hospital care code, then sees her in the afternoon and bills the subsequent care code—this is the intended use of the CPT® codes, right? No way. This is not only incorrect coding, but it will also get the attention of at least one recovery audit contractor (RAC) effective immediately. Background: When CMS started the RAC program, the agency appointed four RAC contractors to implement it, and those companies must post new issues that CMS has approved them...

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