nbeckley(02/19/11)—-In what is being labeled an “important provider notice” DCS, the Region A Recovery Audit Contractor (RAC), has overturned the automated review of untimed codes as well as the review of A000112009 NCCI – OPPS.

The notice posted to its website yesterday, was dated Feb. 16, and involves two issues, including Issue number A000152009 – Untimed Codes.  According to the DCS Statement “letters were mailed to affected providers the first week of February 2011 with notification of the incorrect edit resulting in the overturned automated reviews.”

RACmonitor readers have been continually apprised of the issues of untimed codes through numerous articles over the past 15 months as demand letters for untimed codes were issued improperly, and an update on untimed codes appeared in yesterday’s edition of RACMonitorEnews in an article on Canalith Repositioning.  This past Monday on the Monitor Monday podcast I interviewed Kathleen Parisian, OTR, regarding her therapy company’s experience with untimed codes in Region C, and how they were successful at having the recoupments overturned.

The DCS notice further indicates that DCS is working closely with the MACs to ensure any recouped overpayments are adjusted appropriately and adjustments may take up to four weeks.  Providers should receive a remittance advice that will show reason code N432 for the repayment of any related recouped amounts.

In an important move, DCS is asking providers to allow time for adjustments stating:  “since the overpayment is being rescinded you may choose not to appeal the overpayment.” DCS is further thanking providers for their consideration as they correct the mistake.

Wonders never cease, and hope springs eternal.

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About the Author

Nancy Beckley is a founder and president of Nancy Beckley & Associates LLC, providing compliance planning and outsourced compliance services to rehab providers in hospitals, rehab agencies, CORFs, SNFs and private practice. Nancy is certified in healthcare compliance by the Healthcare Compliance Board.  She is on the Board of the National Association of Rehab Providers & Agencies.  She previously served on the CMS Professional Expert Technical Panel for Comprehensive Outpatient Rehabilitation Facilities.

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