SPOTLIGHT: FY 2010 RAC ADR limits set for all institutional claim types

Last December, the Centers for Medicare and Medicaid Services (CMS) announced the methodology to be used in the Medicare Recovery Audit Contractor (RAC) program for setting additional documentation request (ADR) limits for DRG validation during fiscal year 2010, which began Oct. 1, 2009. Now, that same methodology will be used for reviews of all institutional claim types. "These limits will be set by each RAC [CMS] on an annual basis to establish a cap per campus on the maximum number of medical records that may be requested per 45-day period," says CMS. "A campus unit...may consist of one or more separate facilities/practices under a single organizational umbrella; each limit will be based on that unit's prior fiscal year Medicare claims volume." CMS posting

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