CGI Federal Lists 20 New Issues
Includes 47 DRGs for Overpayment and 4 DRGs for Underpayment
CGI Federal, the RAC for Region B (western states), posted 20 new approved issues for review on their RAC Issues page, on Friday, January 22, 2010. Following the format being used by the Region D RAC, HDI, the listed issues are grouped together by Issue Name, which often includes multiple MS-DRGs.
All of the new issues are approved for DRG Validation, affecting all seven of the Region B states (IL, IN, KY, MI, MN, OH, WI). Notably, one of the new issues posted is approved for underpayment review, although only for four(4) of the five (5) MS-DRGs listed in the issue approved for overpayment review.
None of the new issues mention review of Medical Necessity, although such reviews do not appear to have been approved for any of the RACs, to date. However, it is likely that the existing DRG Validation issues will all be approved for medical necessity review in short order, since the CMS RAC Review Phase-In Strategy allows for such approvals in calendar 2010.
Find links to all the RAC New Issues Pages here. For more useful lists, see below.
Use the links below to see details, in our database:
| 1 |
MSDRGs 189: Acute Respiratory Failure |
| 2 |
MSDRGs 222, 224, 226: Cardiac Defib Implant W Cardiac Cath W/O AMI/HF/Shock W MCC |
| 3 |
MSDRGs 216, 217, 219, 220: Cardiac Valve & Oth Maj Cardiothoracic Procedures w CC or MCC |
| 4 |
MSDRGs 034, 035, 037, 038: Carotid Artery Stent & Extracranial Procedures w CC or MCC |
| 5 |
MSDRGs 231, 233, 235: Coronary Bypass W PTCA/Cardiac Cath w MCC |
| 6 |
MSDRGs 131: Cranial/Facial Procedures w CC or MCC |
| 7 |
MSDRGs 020, 021, 023, 025, 026: Craniotomy, Endovascular and Intracranial Vascular Procedures w CC or MCC |
| 8 |
MSDRGs 113, 116, 121, 124: Disorders Of The Eye, Infections And Procedures (Orbital And Interocular) w CC or MCC |
| 9 |
MSDRGs 689: Kidney & Urinary Tract Infections w/MCC |
| 10 |
MSDRGs 237: Major Cardiovasc Thoracic Aortic Aneurysm Repair Procedures w CC or MCC |
| 11 |
MSDRGs 163, 164: Major Chest Procedures w CC or MCC |
| 12 |
MSDRGs 129: Major Head & Neck Procedures w CC or MCC |
| 13 |
MSDRGs 228, 229: Other Cardiothoracic Procedures w CC or MCC |
| 14 |
MSDRGs 133: Other Ear, Nose, Mouth & Throat O.R.Procedures w CC or MCC |
| 15 |
MSDRGs 246, 248, 250: Perc Cardiovasc Proc W Drug-Eluting Or Non Drug Eluting Stent w MCC or 4+ Vessels/Stents |
| 16 |
MSDRGs 041, 042: Periph/Cranial Nerve & Other Nerv Syst Proc w CC or MCC |
| 17 |
MSDRGs 028, 029: Spinal Procedures Neurostimulators W CC or MCC |
| 18 |
MSDRGs 003, 004, 011, 012, 013: Tracheostomy |
| 19 |
MSDRGs 004, 011, 012, 013: Tracheostomy – Underpayment |
| 20 |
MSDRGs 031, 032: Ventricular Shunt Procedures W CC or MCC |
Find a list of all their posted issues HERE. (Registration required.)
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Tags: cgi, CMS, medical coding, rac, rac new issues, RAC New Issues Alerts, rac region b, recovery audit contractor
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on Tuesday, January 26th, 2010 at 12:49 pm and is filed under Medical Coding News, RAC New Issues Alerts.
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