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Ask a Consultant
RAC Repayment Demand – Query
I just received a demand for payment from the RAC program for $32.46. I treated a patient with a non-displaced fibula fracture with a BK CAM boot and crutches. I coded 99212-25 and 27786,73610 on 1-29-09. The audit claims the evaluation and management is part of the fracture care.
Should I appeal for $32.46?
Back then (3 years ago), my records were hand-written and not as comprehensive as they are now with EHR. Am I exposing myself to further inquiry by sending my admitedly inadequate records?
Doctor Name Withheld
Conclusion
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Filed under: "Ask-an-Advisor", Practice Management | Tagged: CPT, CPT codes, MC, Medical Practice RAC Audit, medicare, RAC Audit |
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According to PM News #4,346 while no one can guarantee what will happen; in general, paying back a small sum based on a single, isolated case does not expose one to further inquiry. Sending in “admittedly inadequate records”, however, can expose one to further audits.
Ann Miller RN MHA
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OMG
All this turmoil for $32.46?
Docs, this is your third-party future.
Get used to it.
Office Manager
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