Region B RAC Adds Review of Inpatient Admit Orders, 95 DRG Validations
In the continuing posting of issues, the RAC contracted for the upper midwestern states, CGI Federal, has now joined Connolly Healthcare in its posting of an issue that can possibly recoup all Medicare Part A charges for an inpatient claim, and still not even touch the dreaded issue of Medical Necessity.
The List
Below are the 15 new issues, posted last week. Follow the links to each one, in the eduTrax RAC New Issue Database®, which can be seen with simple free registration at myedutrax.com.
| 1 |
Date of Death-DME |
| 2 |
Inpatient Admissions without a Physician’s Inpatient Admit Order |
| 3 |
MSDRG 052, 053, 054, 055, 056, 057, 058, 059, 060, 061, 062, 063, 067, 068, 069, 070, 071, 072, 073, 074, 077, 078, 079, 080, 081, 082, 083, 084, 085, 086, 088, 089, 090, 091, 092, 093, 097, 098, 099, 101, 102: DRG Validation for Nervous System Disorders |
| 4 |
MSDRG 165: DRG Validation for Major Chest Procedures |
| 5 |
MSDRG 168: DRG Validation for Other Respiratory System O.R. Procedures |
| 6 |
MSDRG 175, 176, 180, 181, 182, 183, 184, 185, 186, 187, 188, 192, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206: DRG Validation for Respiratory |
| 7 |
MSDRG 242, 243, 244: DRG Validation for Permanent Cardiac Pacemaker Implant |
| 8 |
MSDRG 247, 249, 251: DRG Validation for Percutaneous Cardiovascular Procedures |
| 9 |
MSDRG 326, 327, 328: DRG Validation for Stomach, Esophageal and Duodenal Procedures |
| 10 |
MSDRG 371, 372, 373: DRG Validation for Major Gastrointestinal Disorders and Peritoneal Infections |
| 11 |
MSDRG 405, 406, 407: DRG Validation for Pancreas, Liver and Shunt Procedures |
| 12 |
MSDRG 474, 475, 476: DRG Validation for Amputation for Musculoskeletal System and Connective Tissue Disorders |
| 13 |
MSDRG 490, 491: DRG Validation for Spinal Fusion |
| 14 |
MSDRG 533, 534, 537, 538, 562, 563: DRG Validation for Musculoskeletal Fractures |
| 15 |
Prosthetic Additions When Billed With Initial Or Preparatory Knee Prosthesis |
More to Come
We’ll have more to say about the review of Physician orders, soon…
Tags: cgi, CMS, Connolly Healthcare, medical coding, medical documentation, medical necessity, medicare reimbursements, rac region b, racs, recovery audit contractors
This entry was posted
on Sunday, July 25th, 2010 at 5:53 pm and is filed under From the road..., Medical Coding News, RAC New Issues Alerts, Uncategorized.
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