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.


Showing 21-30 of 151 entries
Issue Name Review Type Provider Type MAC Jurisdiction Date Approved
0014 - Glucose Monitor Supplies When Billed With Same Dates of Service as Glucose Monitor: Unbundling Automated DME Physician/DME Supplier All DME MACs
0155-Upper Limb Orthotics within the Reasonable Useful Lifetime: Excessive Units Automated DME Physician/ DME Supplier All DME MACs
0079 - Ventilators: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0016 - Continuous Passive Motion Billed without Total Knee Replacement or Total Knee Revision Automated DME Physician/DME Supplier All DME MACs
0026 - Nebulized Drugs: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0152-Blood Glucose Test or Reagent Strips: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0220-Hip Orthoses within the Reasonable Useful Lifetime: Excessive Units Automated DME Supplier, DME Physician All DME MACs
0141-Therapeutic Shoes and Inserts for Persons with Diabetes: Medical Necessity and Documentation Requirements Complex DME Physician/ DME Supplier All DME MACs
0128-Spinal Orthoses within the Reasonable Useful Lifetime: Excessive Units Automated DME Physician/DME Supplier All DME MACs
0013 - Ankle-Foot Orthoses and Knee-Ankle-Foot Orthoses: Medical Necessity and Documentation Requirements Complex DME Physician/DME Supplier All DME MACs
Page Last Modified:
09/06/2023 05:05 PM
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