DecisionHealth, DecisionHealth - 2011 Issue 5 (May)

Beware of RACs that shoot first, ask questions later on CCI edits

Prepare to defend any of your codes affected by National Correct Coding Initiative (CCI) edits against CMS’s recovery audit contractors (RACs), which have begun using the edits as targets for overpayment demands. Two cases in Pennsylvania – a major integrated delivery system called WellSpan Health and a much smaller urology practice – offer evidence that you must pay close attention to CCI changes.

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