CMS dropped consultation codes (CPT codes 99241-99255) on Jan. 1, 2010, but RACs could still review the last two years of those payments because they operate under a three-year look-back period, wrote Mr. Spencer, a compliance officer for Fi-Med Management, a physician practice financial management company based in Wauwatosa, Wis.
Currently RACs are not approved to audit consultation codes, but if they did gain approval they could have a field day, Mr. Spencer said. In the upper Midwest, for example, the payment error rate for consultations was above 40 percent at one point, according to the firm WPS.
Mr. Spencer is crossing his fingers. Each day RACs continue to lack approval to monitor consultation codes, he wrote, means “one day’s worth of consultations fall off the review table, which in turn means that the news continues to get better.”
Read the RAC Monitor report on consultation codes.
Read Mr. Spencer’s RAConteur blog.
Read more recent coverage of RACs.
– Medicaid RAC Implementation Date Postponed
– RACs Can Request Claims Not on Approved List
– 10 Tips on Improving RAC Readiness From Kaiser’s RAC Expert