Five RAC Coding Targets

Wilson, Donna D.
May 2009
Journal of AHIMA;2009, Vol. 80 Issue 5, p64
The article focuses on the Recovery Audit Contractors (RACs) in the U.S. The Centers for Medicare and Medicaid Services (CMS) expects four RACs to be operational by 2010 that will identify improper payments of Medicare payments. A demonstration program on how RACs operates shows that most overpayments come from inpatient hospital providers. The program identifies key areas of improper payments due to incorrect inpatient coding including excisional debridement and wrongful diagnosis.


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