Newly approved Recovery Auditor issues – 05/04/2016

HealthDataInsights (HDI) posted one new issue in one category to its CMS list for providers in Region D. (See link for individual state applicability.)

According to the HDI website, the new issues are:

For outpatient hospitals:

• Trauma Activation with Critical Care Services. The Medicare Claims Processing Manual, Chapter 4-Part B Hospital §160.1 Critical Care Services states "Only patients for whom there has been prehospital notification based on triage information from prehospital caregivers, who meet either local, state or American College of Surgeons field triage criteria, or are delivered by inter-hospital transfers, and are given the appropriate tam response can be billed a trauma activation charge."