RAC audits are imminent

The first step in the dreaded RAC audit process has begun. Connolly Healthcare, the RAC handling a large portion of the southeast and south-central U.S., has posted the first set of issues that will be eligible for review on its website.

Those issues include proper coding for blood transfusions; untimed codes; IV hydration therapy; bronchoscopy services; once-in-a-lifetime procedures; pediatric codes exceeding age parameters; and Injection, Pegfilgrastim, 6mg. These all will be subject to automated review, which is where RAC audits are all going to begin.

Don't get a false sense of security out of the fact that your RAC hasn't published a list yet, experts warn. While the issues are only approved currently for outpatient hospital and physician providers in South Carolina, it's likely that RACs in other jurisdictions will pick up on them and consider them for review, as well.

To learn more about the upcoming reviews:
- read this Health Leaders Media piece

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HFMA ANI 2009: Tenet's experiences with RACs

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