Aug 09
13
Region C RAC Posts Approved CMS Issues – Rehab Included
The RAC for Region C, Connolly Healthcare, was the first to post CMS approved issues for automated review. The seven issues posted included rehab, which comes as no surprise as the issue selected is one of billing for untimed codes (service-based codes). They are looking for claim where service based codes have been billed for more than one (1) unit of service. In the RAC demonstration (2007) $3.2 million in claims for speech therapy evaluation were found to be billed in units greater than one.
In posting this issue Connolly (nor has CMS) has not limited the review to speech therapy evaluations, but rather indicates untimed codes. Untimed codes include the physical therapy and occupational therapy evaluation (and re-evaluation) codes as well as other modality and procedure codes that are untimed.
Read my July 15th article in RACMonitor.com to see my prediction on Likely Rehab RAC Targets: Hiding in Plain Sight. Other likely rehab issues to be approved by CMS for RAC review are detailed.
