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Proposed RAC Topics

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Issue Name Review Type Claim Type Region and State Date Posted
0A024-Inpatient Rehabilitation Facility (IRF) Stays: Meeting Requirements to be considered Reasonable and Necessary Complex IRF RAC 1-4
All States
08/07/2018
0A085-Parenteral Nutrition:Medical Necessity Complex DME by Supplier; DME by Physician RAC 1-4
All States
08/07/2018
5A092-Custom Fabricated Knee Orthoses: Medical Necessity Complex DME by Supplier; DME by Physician RAC 5
All States
2018-08-07
0A113-Transthoracic Echocardiography Complex Inpatient Hospital, Outpatient Hospital, SNF, CAH CGS, First Coast, NGS, Palmetto 2018-08-07
4A096-Facility vs. Non Facility Reimbursement Automated Professional Services-Physician/Non-Physician Practitioner RAC 1-4
All States
2018-08-07
5A106-DME while in Hospice Automated DME by Supplier; DME by Physician RAC 5
All States
2018-08-07
4A110-Skilled Nursing Facility (SNF) Consolidated Billing Part B (Partial) Automated Professional Services-Physician/Non-Physician Practitioner RAC 1-4
All States
2018-08-07
4A116-MCP (Monthly Capitation Payment) for ESRD (End-Stage Renal Disease) Receiving 4 or more visits per month Automated Professional Services (Physician/Non-Physician Practitioner) RAC 1-4
All States
2018-08-07
0A123-Radiologic Examination of the Chest Automated Outpatient Professonal Services Noridian (JE, JF) 2018-08-07
4A109-Skilled Nursing Facility (SNF) Consolidated Billing Part B (Full) Automated Professional Services-Physician/Non-Physician Practitioner RAC 1-4
All States
2018-08-07
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