Approved RAC Topics
Approved RAC Topics
Do you have questions or concerns about the Recovery Audit Program? Please e-mail us at RAC@cms.hhs.gov. Please Do Not send Personal Health Information to this e-mail address.
Note: CMS often receives referrals of potential improper payments from the MACs, UPICs, and Federal investigative agencies (e.g., OIG, DOJ). At CMS discretion, CMS may require the RAC to review claims, based on these referrals. These CMS-Required RAC reviews are conducted outside of the established ADR limits.
Showing 141-145 of 145 entries
| Issue Name Sort descending | Review Type | Provider Type | MAC Jurisdiction | Date Approved |
|---|---|---|---|---|
| 0219-Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac Joint: Medical Necessity and Documentation Requirements | Complex | Ambulatory Surgical Center (ASC); Outpatient Hospital; Professional Services | J5, J6, J8, J15, JJ, JK, JM | |
| 0220-Hip Orthoses within the Reasonable Useful Lifetime: Excessive Units | Automated | DME Supplier, DME Physician | All DME MACs | |
| 0221- Hospice Care- Extended Length of Stay: Medical Necessity and Documentation Requirements | Complex | Hospice | HH/Hospice MACs | |
| 0222-Non-Physician Billed Without Correct Assistant at Surgery Modifier: Incorrect Coding | Automated | Professional Services | All A/B MACs | |
| 0223-Drugs and Biologicals in Multi-Dose Vials: Billed with JW Modifier | Automated | Outpatient Hospital, Professional Services | All A/B MACs |
Page Last Modified:
11/19/2024 05:55 PM