Wiki RAC requests

[MRandles]

Has anyone seen an increase in RAC requests regarding a specific code?

We have been seeing it with 99223, particularly aimed at the MDM portion of the note.

Thought it would be nice to share this information so everyone has a heads up and maybe be proactive.

I know this is included in the OIG workplan and it wasn't a surprise.

Any other codes we should focus on where there's been an increase?

 

[Pam Warren]

99223 seems to be the target code so far. You're correct--- MDM (as well as medical necessity) is being scrutinized.

We've had other payer audits with regards to 99215 and 99245 and 99255. Gotta love it.