Connolly Healthcare, the RAC for Region C, has posted new CMS-approved audit issues, including the first for ambulatory surgery center claims, according to the Connolly website and an HCPro Revenue Cycle Institute blog.
The new ASC issue is as follows:
Issue name: Payments for Ambulatory Surgical Center Services Provided to Beneficiaries in Skilled Nursing Facility Stays Covered Under Medicare Part A
Description: Payment for the majority of Skilled Nursing Facility (SNF) services provided to beneficiaries in a Medicare covered Part A SNF stay are included in a bundled prospective payment made through the fiscal intermediary (FI)/A/B Medicare Administrative Contractor (MAC) to the SNF. These bundled services are to be billed by the SNF to the FI/A/B MAC in a consolidated bill.
States affected: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virgin Virginia and West Virginia (Also Puerto Rico and the Virgin Islands)
View the Connolly website announcing the first issue for ambulatory surgery center claims.
Read the HCPro blog about the new ASC audit issue.