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 91-100 of 151 entries
Issue Name Review Type Provider Type MAC Jurisdiction Date Approved
0146-Computed Tomography Scans: Excessive Units Automated Outpatient Hospital; Professional Services All A/B MACs
0147-Magnetic Resonance Imaging Procedures: Excessive Units Automated Outpatient Hospital; Professional Services All A/B MACs
0148-Same Knee Orthosis within Reasonable Useful Lifetime: Excessive Units Automated DME Physician/ DME Supplier All DME MACs
0149-Subsequent Hospital Visit and Discharge Day Management on the Same Day: Unbundling Automated Professional Services All A/B MACs
0150-Mohs Micrographic Surgery: Incorrect Coding and Incorrect Units Billed Complex Professional Services All A/B MACs
0151-Physician/Non-physician Practitioner Coding Validation Complex Professional Services All A/B MACs
0152-Blood Glucose Test or Reagent Strips: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0153-Ambulatory Surgical Center Coding Validation Complex Ambulatory Surgical Center (ASC) All A/B MACs
0154-Non-Emergency Ambulance Services- Advanced Life Support and Basic Life Support: Medical Necessity and Documentation Requirements Complex Laboratory/Ambulance All A/B MACs
0155-Upper Limb Orthotics within the Reasonable Useful Lifetime: Excessive Units Automated DME Physician/ DME Supplier All DME MACs
Page Last Modified:
11/19/2024 05:55 PM
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