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The fourth CMS Recovery Audit Contractors (RAC) posted ten new issues including 87 DRG Validations, late on June 23. Medical Necessity is still not approved for review under any of these issues.
Region B
The RAC for Region B (CGI) posted ten new issues, including 87 DRG Validations. All the new issues are listed below, including links to their descriptions in the eduTrax® RAC New Issues pages.
To see these pages, you will need to login to the eduTrax main site.
| MS-DRGs 592, 593, 594, 595, 596, 602, 603, 604, 605, 606, 607: DRG Validation for Skin Disorders |
| MS-DRGs 826, 827, 828, 829, 830, 834, 835, 836: DRG Validation for Neoplasm Surgery |
| MS-DRGs 856, 857, 858, 862 863: DRG Validation for PostOp or Post Traumatic Infection |
| MS-DRGs 837, 838, 839, 843, 844, 845, 846, 847, 848, 849: DRG Validation for Neoplasm |
| MS-DRGs 329, 330, 331: DRG Validation for Major Small and Large Bowel Procedures |
| MS-DRGs 685, 686, 687, 688, 690, 695, 696, 697, 698, 699, 700: DRG Validation for Kidney and Urinary Tract Disorders |
| MS-DRGs 734, 735, 736, 737, 738, 739, 740, 741, 742, 743, 744, 745, 746, 747, 748, 749, 750: DRG Validation for Female Reproductive Disorders |
| MS-DRGs 614, 615, 625, 626, 627, 628, 629, 630: DRG Validation for Endocrine, Nutritional & Metabolic Disorders |
| MS-DRGs 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 923: DRG Validation for Disorders Related to Injuries/Toxicity |
| MS-DRGs 471, 472, 473: DRG Validation for Cervical Spinal Fusion |
Sortable Lists
To find a free complete, sortable listing of all their posted issues, visit this page on eduTrax. (Registration required.) We recommend viewing the list, sorted by Approved Date.
To see the complete original listings (on the RAC websites), visit this page.
When Will Medical Necessity Reviews Begin?
No one knows but the RACs, and so far, they ain't sayin'. BUT -- If you would like to be notified by email whenever they do get posted, simply to the click here to subscribe for free to the eduTrax RAC New Issues Alert Service®. We post new issues, as in this article, and will send out an email notice immediately when medical necessity issues begin posting on the RAC websites. |
