Wiki 93000 and RAC

[maine4me]

I recently received RAC audits for 93000. They were billed with ICD9 V72.83. I have pulled the LCD and this dx code is on the list. What is unclear to me is if another codes needs to be billed along with it. Does anyone have any idea?

 

[Pam Warren]

A couple of things come to mind....are you billing provider-based? I had heard through the grapevine that the RAC was looking at charges that might bump up against the 72 hour rule.

Also, does the provider own the EKG equipment? The RAC is looking into global charges for diagnostics when only the pro-fee should be billed.

By any chance these aren't NH Medicaid claims are they? There's been a big ruckus lately with these letters (sent by a Maine company named Goold) because the requests are in error, which they've actually admitted.

That's all I can think of....print out the LCD and appeal the RAC.