Eli's Rehab Report
Careful -- RACs Are Watching Your Untimed Therapy Codes
The Centers for Medicare & Medicaid Services' notorious Recovery Audit Contractors are going after more than just inpatient rehab facilities. Two RACs, Connolly Healthcare and Health Data Insights, Inc., have their eyes on outpatient therapy, particularly untimed therapy codes, according to the Aug. 14 edition of PT Bulletin Online. For example, Connolly Healthcare's Web site indicates that providers should enter only "one" in the units billed column per date of service. An example of an untimed code would be a PT or OT evaluation (97001 or 97003). The RAC also mentioned that it would not consider modifiers KX or 59 in these CPT codes. Remember:
"While Region C consists of several states, it appears Connolly will target its efforts in South Carolina at this time," the Bulletin said. "Health Data Insights will target claims in all 20 states under its authority. RACs for Regions A and B, have not yet listed information about their auditing activities on their Web sites."
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