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Targeted Review

New Denial Code for RACs

by RacGuru on May 19, 2010

in RAC News

Effective May 24, 2010, the CMS will institute a new denial code (N432) that is specifically a message to you (the physician’s office) that reimbursement has been held back due to a RAC audit. Specifically, “When possible, the Remittance Advice shall contain an N432 code to let the provider know that the adjustment is the [...]

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Random Selection of Claims

by RacGuru on February 18, 2010

in RAC News

Can a RAC “stumble” across my files via random selection? The RAC shall adhere to Section 935 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003, which prohibits the use of random claim selection for any purpose other than to establish an error rate…the RAC shall not use random review in order to [...]

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