Medicare Compliance & Reimbursement

Tip: Even if you voluntarily refund improper payments to your MAC, the RAC might still audit the claim. If you've been sweating it out, waiting for the recovery audit contractors (RACs) to announce where they'll be focusing their audit efforts, two RAC contractors have answers. CMS appointed four RAC contractors to implement its program, but CMS must approve any review issues and the RACs must post them to their Web sites. At this point, just two contractors, Connolly Consulting Inc. (which handles Region C) and HealthDataInsights (Region D) have announced their review areas. The review areas are as follows: • Blood transfusion codes 36430-36455, which should be billed once per session, despite how many units are transferred. • Untimed codes, excluding modifiers KX and 59. You should bill one unit of these codes per date of service. • IV hydration therapy (formerly code 90760, now 96360). You should report just [...]