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.

RAC Topic

Showing 81-90 of 151 entries
Issue Name Review Type Provider Type MAC Jurisdiction Date Approved
0135-Cardiac Rehabilitation: Medical Necessity and Documentation Requirements Complex Outpatient Hospital All A/B MACs
0136-Radiologic Examination of the Chest: Medical Necessity and Documentation Requirements Complex Outpatient Hospital All A/B MACs
0138-Skilled Nursing Facility Consolidated Billing for Therapies: Unbundling Automated Professional Services All A/B MACs
0139-Vertebroplasty or Kyphoplasty: Medical Necessity and Documentation Requirements Complex Ambulatory Surgical Center (ASC); Outpatient Hospital; Professional Services All A/B MACs
0140-Pulmonary Rehabilitation: Medical Necessity and Documentation Requirements Complex Outpatient Hospital All A/B MACs
0141-Therapeutic Shoes and Inserts for Persons with Diabetes: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0142-Ambulatory Surgical Center Services Billed During a Covered Part A Skilled Nursing Facility Stay: Unbundling Automated Ambulatory Surgical Center (ASC); Skilled Nursing Facility (SNF) All A/B MACs
0143-Vitamin D Assay Testing: Medical Necessity and Documentation Requirements Complex Laboratory/Ambulance JE/JF
0144-Prefabricated Knee Orthoses: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0145-Endovenous Radiofrequency Ablation and Endovenous Laser Treatment for Lower Extremity Varicose Veins: Medical Necessity and Documentation Requirements Complex Ambulatory Surgical Center (ASC); Professional Services All A/B MACs
Page Last Modified:
11/19/2024 05:55 PM
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