Home Health & Hospice Week

Wheelchair appeal targets unfair recoupment amount. Some providers aren't taking what they view as unfair RAC denials lying down. Case in point: A durable medical equipment company is appealing a Recovery Audit Contractor recoupment involving what the RAC claims to be noncompliant billing for a power wheelchair. The billing allegedly violated some bundling rules that are part of a local coverage decision, reports attorney Amy Fehn, whose law firm is handling the appeal for the DME provider. "The issue involves armrests," adds Fehn, where the local coverage determination (LCD) policy "has a chart saying if you are providing this code and this code, they should be bundled with a certain other code." The guidance, however, on the bundling issue isn't very clear, she adds. And, "even if there is an error, it may be a $20 error whereas the RAC is trying to disapprove thousands of dollars by denying the [...]