HealthDataInsights, Inc., the Medicare recovery audit contractor for Region D, has initiated automated audits to verify the accuracy of seven hospital outpatient and physician codes on Medicare claims paid since Oct. 1, 2007.
Issues under scrutiny are:
- Newborn pediatric CPT codes billed for patients exceeding age limit
- Once in a lifetime
- Excessive units-untimed codes
- Excessive units-blood transfusions
- Excessive units-bronchoscopy
- Excessive units- IV hydration
- Neulasta
HealthDataInsights, based in Las Vegas, is conducting outreach sessions with hospitals and other healthcare providers before launching the audits in each state.
The Region D states are Alaska, Arizona, California, South Dakota, North Dakota, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, Oregon, Utah, Washington and Wyoming.