Audits: HDI RAC Targets TC, Modifier 26 & More

January 26, 2010

Want to know what RAC contractors will be looking for next? Here’s the link.

Recovery audit contractors (RACs) are working hard to expand their lists of approved issues, and you should keep a close eye on your services in these areas as well.

Health Data Insights (HDI), the RAC contractor for Region D, posted 66 new approved issues for review in January, with the following just a small sample of what HDI plans to review going forward:

• Global surgery pay versus technical component (TC)/professional component (modifier 26) and

• New patient versus established patient cases.

Keep in mind: When a RAC lists its open issues, it also lists the applicable states where it is reviewing them. Some issues are under review for all states that fall into a particular RAC’s purview, while others may be applicable to just one or two states.

Bottom line: To stay on top of the issues that your RAC is reviewing, check in on the applicable Web site from time to time.

To learn more about what the RACs are doing in YOUR region, go here.

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If you think the RACs are the only auditors you need to worry about, think again. Meet the MICs.

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