Part B Insider (Multispecialty) Coding Alert
Look for RAC Demand Letters Directly From Your MAC
Plus: Physician + Ministers + Supplier = Medicare Fraud? You've been waiting for years to hear the good news that recovery audit contractors (RACs) will cease sending demand letters to providers, and that time has finally come--with a catch. Although RACs will no longer send out demand letters, CMS has simply transferred the responsibility of that task to processing contractors. "When a recovery auditor finds that improper payments have been made to you, they will submit claim adjustments to your Medicare (claims processing) contractor," CMS says in new MLN Matters article MM7436. "The Medicare contractor will follow the same process as is used to recover any other overpayment from you." Once you get word from your MAC that it is seeking RAC monies, you'll stay in touch with the MAC regarding any issues about time frames and appeals. However, if you have audit-specific questions "such as the rationale for identifying the potential improper payment," you'll contact the recovery auditor personally, CMS notes. For more information about this change, visit www.cms.gov/MLNMattersArticles/Downloads/MM7436.pdf.
Part B Insider (Multispecialty) Coding Alert
- Part B Payment:
Government's Debt Deal Could Hurt Your Medicare Pay
Medicare cuts are on the back burner for now, but will be on the docket [...] - Diagnosis Coding Quiz:
Are Your Dx Coding Skills Up to Snuff? Take This Quick Quiz to Find Out
Hint: Coders shouldn't be interpreting test results to get quick diagnosis codes.As your practice continues [...] - Part B Mythbuster:
Don't Forget to Check Secondary Coverage When Reporting Preventive Exams
Tip: Obtain Medicare denial so the claim can cross over.Myth: You can't bill for a [...] - On-call Services:
Avoid On-Call Fraud Accusations With These FAQs
Beware: You can't capture ER coverage services with after-hours codes.If you bill incorrectly when your [...] - Part B Coding Coach:
4 Common Interventional Pain Management Procedures You Can't Afford To Miss
Get the lowdown on when to code separately for fluoroscopy.If your physician performs interventional pain [...] - Physician Notes:
Look for RAC Demand Letters Directly From Your MAC
Plus: Physician + Ministers + Supplier = Medicare Fraud?You've been waiting for years to hear [...] - In other news
A Louisiana church health fair may have offered more than medical flyers--it also was accused [...] - Reader Question:
Don't Expect Payment For 'Healthy' Appendectomy
Question: I heard that Medicare will not pay separately for the removal of a healthy [...] - Reader Question:
Blink And You'll Have Missed Specialty Code 95
Question: Can you clarify under which circumstances we'll need to use specialty code 95 for [...]
