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Medicare Compliance & Reimbursement

Audits:

RACs Are Now Checking Your Modifier 25, Injection Claims

Published on Mon Apr 09, 2012

Plus: Contractors are also auditing place of service, bilateral services, and consolidated billing. Your practice may have grown accustomed to the presence of recovery audit contractors (RACs) in the Medicare world, but it can still be hard to follow the issues that the RACs are investigating. Check out the following five recently-posted RAC focus areas so you know what they're seeking, and find out how you can stay out of the auditors' crosshairs. Consolidated Billing Region D RAC, Health Data Insights, announced on Jan. 28 that it will be reviewing claims for SNF consolidated billing for therapies provided during a patient's Part B skilled nursing facility (SNF) stay. Background: Medicare's "consolidated billing" is a payment methodology that reimburses nursing facilities in a lump sum payment for all facility services the patient may need during the course of a Part A stay. Because Part A typically covers nursing facility patients and [...]
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