Results 1 to 3 of 3

RAC question

  1. #1
    Default RAC question
    Medical Coding Books
    Have received a couple of recovery requests from my Medicare carrier's RAC. If the coding error was a missing modifier and we are within the year of timely filing, can we appeal the recovery and submit a corrected claim to keep the payment?? I went to a seminar back in March and the guy confused me. He made it sound like we could appeal the coding errors vs. refunding the carrier. Anyone have expert knowledge of the RAC process and what the provider rights are??

  2. Default
    I would be interested to know this answer too. We had a RAC audit that revealed one of the providers billed a 99203 (new pt E/M) which should have been a 99214 b/c the patient was seen as a Hospital consult 2 days before they came in the office for the first time. I am considering doing a redermination notice as a corrected claim. Does anyone have any experience with this? Still researching.....

    Anna Barnes, CPC, CEMC

  3. #3
    Idaho Falls, Idaho
    You need to refund the money to the RAC first. Then you have a limited time to appeal their decision, through them. Your best bet is to get on their website, and look over their appeal process. They are usually long and very detailed, and you want to follow it to the "T". Good luck!
    Tesja Erickson, CPC, CPMA COBGC, CEMC
    The Coding Surgeon
    Medical Documentation & Coding Consultant
    2012 AAPC Idaho Falls Chapter President
    2011 AAPC Idaho Falls Chapter President-Elect

Similar Threads

  1. 2009 RAC audit question
    By tbunch in forum Cardiology
    Replies: 2
    Last Post: 01-12-2012, 04:01 PM
  2. Rac
    By in forum Employment General Discussion
    Replies: 1
    Last Post: 06-29-2011, 08:59 AM
  3. Rac
    By LACEY13 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 08-11-2010, 03:04 PM
  4. Rac
    By Stacyharter98 in forum Medicare Regulations
    Replies: 3
    Last Post: 07-28-2009, 07:10 AM
  5. Rac
    By 007CPC in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-24-2009, 06:11 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.