Monday, August 10, 2009

South Carolina RAC Releases List of Audit Areas

Connolly Consulting, the Medicare Recovery Audit Contractor (RAC) of Region C, has released the first set of issues eligible for audit. While these areas only apply to South Carolina at the moment, it is believed that other states will eventually adopt these areas as well.

The RAC program was developed to help identify areas of overpayment and underpayment in the Medicare system. The RAC reviews claims histories to determine improper payment situations, offsetting overpayments with underpayments when possible.

The areas of audit include announced for Region C include:
  • Blood transfusions;
  • Untimed codes;
  • IV Hydration therapy;
  • Bronchoscopy services;
  • Once in a lifetime procedures;
  • Pediatric codes exceeding age limits;
  • And Pegfilgrastim injections.

Source: Modern Healthcare

1 comment:

Unknown said...

The Senate Democratic health care reform bill provides for the expansion of the Recovery Audit Contractor program. See my Medicare Update post at