The first flight of three eCourses, The Prep Pack, focuses on lessons learned from the RACs, especially on the subject of high dollar overpayments and the lack of documentation to support medical necessity. The second and third eCourses, Coding and Billing for Principal Diagnosis and Coding and Billing for Secondary Diagnoses respectively, discuss how the RACs used data scrubbers to identify claims that had the highest probability of DRG changes, the reverse of an encoder.
The second flight of three eCourses is called the Hot Spots #1 Pack. The first eCourse delves into coding and documentation of “hot spots,” areas that the RACs had attacked during the demonstration. The second eCourse, Medically Unlikely Edits, tackles this much-discussed topic. At last count, there were over 8,000 with more to be added this month. Equally important is the third eCourse, Excisional Debridements. In this course, you will learn why RACs will be particularly focused in this area once the program resumes. Excisional Debridements accounted for more than $36.2 million in recoupments in the initial three-state demonstration including California, Florida and New York. It’s obvious that the RACs will be paying close attention to this targeted area so it’s best to prepare now and this eCourse will get you and your facility positioned correctly.
The final flight of three eCourses Hot Spots #2, provides an in-depth look at particularly vexing areas: The first eCourse covers Colonscopies & EGDs. The second one is devoted to the intricacies of Coding and Billing for Outpatient Rehabilitation Services and the third is focused on Coding and Billing for Drugs and Biologicals. You and your team will learn about these key targeted areas based on findings from RACs reports and CMS.
Traditionally, January is the month for making resolutions. Putting RAC education high on your resolution list is a good place to begin and a strategically smart resolution.
As the ancient proverb goes, “It’s better to seek knowledge before you need it than to seek knowledge when you have to.”
For more information on RACUniversity and the special educational offering, go to RACUniversity on the RACMonitor.com home page.