In Audit
Nov 13th, 2014
Recovery audit contractors (RACs) have recouped millions of dollars for excisional debridements that weren’t really excisional, or that weren’t fully documented to support the coding reported. In CPT® terms, think of the skin debridement codes in the 10000 section as excisional, and the debridement codes found in the 90000 section as non-excisional. As explained in ...
In CMS
Mar 26th, 2013
If you receive a letter from a Medicare recovery audit contractor (RAC) regarding overpayment, don’t panic! You may think you only have two options: pay up or launch an appeal. There is another option, however, if you move fast (before a formal appeals process starts) and are certain the RAC is mistaken about the overpayments. ...
Dec 1st, 2012
By Amy Lee Smith, MBA, CPC, CPC-H, CPMA, CIA, CRMA  Preparing for, and responding to, recovery audit contractor (RAC) reviews can be intimidating. You can lessen the pain, however, by understanding Medicare billing and coding rules and requirements, and being proactive in implementing controls to ensure compliance. RACs Review Across the Nation Section 302 of ...
Nov 1st, 2012
By David Lane, PhD, CHC, CPC, CAPPM “Compliance” often conjures up images of boring lectures, law enforcement, huge fines, scary “I’m from the government and I’m here to help” mentality, and worse. In reality, compliance is an integral part of the health field. And with health care reform and the Patient Protection and Affordable Care ...
Sep 1st, 2012
By Marcella Bucknam, CPC, CPC-H, CPC-P, CPC-I, CCC, COBGC, CCS, CCS-P The surgical package is a reimbursement concept that bundles all typical care related to a specific surgical service into a single payment. Many surgeons find information about what is bundled confusing, and either inappropriately bundle all of their work into a single payment or ...