Newly approved Recovery Auditor issues - 02/24/2016

Performant Recovery posted one new issue in one category to its CMS list for providers in Region A. (See link for individual state applicability.)

According to the Performant website, the new issue is:

For DME supplier:

• Respiratory Assist Devices-JA. Potential incorrect billing may have occurred for Respiratory Assist Devices (RAD), that did not meet the medical necessity requirements as described in the NHIC Local Coverage Determinations L33800 and L11504.

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

According to the Cotiviti website, the new issue is:

For IP-IRF:     

• Documentation Review: Inpatient Rehab Hospital-IP-C000382015. Documentation will be reviewed to determine if the billing of Inpatient Rehab Hospital services meet Medicare coverage criteria. Medical Necessity will be excluded from this review. Applicable region C states.