Watch the RAC Websites for Medical Necessity Issues...

The AHA reports that CMS' New Issue Review Board approved the first "medical necessity review" audits last week.  The  audits include eighteen types of inpatient hospital claims and one type of DME claim. Remember that the RAC's must post the issues on their websites before issuing Additional Documentation Requests.  CMS expects the RACs to post the new audits and begin issuing ADR's within the next two weeks.  So, watch the RAC websites.  For your convenience, the issue pages on the RAC websites are:

Region A: Diversified Collection Services (DCS) - http://www.dcsrac.com/issues.html

Region B: CGI - http://racb.cgi.com/Issues.aspx

Region C: Connolly, Inc. - http://www.connollyhealthcare.com/RAC/pages/approved_issues.aspx

Region D: HealthDataInsights, Inc. - https://racinfo.healthdatainsights.com/Public1/NewIssues.aspx

Remember that MediRegs tracks the RAC Issues pages for you (for the RAC's that have given us permission) and the CMS RAC page.