Updated on: January 31, 2013

RAC Region A Posts Issues by Major Diagnostic Category

Original story posted on: January 22, 2012









DCS Healthcare has changed how it posts issues from listing individual MS-DRGs to major diagnostic categories (MDCs).

Providers should note that each category includes several MS-DRGs that the Region A recovery auditor (RAC) will review. For example, MDC 5 (diseases and disorders of the circulatory system) lists eight MS-DRGs, including MS-DRG 239 (amputation for circulatory system disorders except upper limb and toe with major complications and comorbidities) and MS-DRG 298 (cardiac arrest, unexplained without complications and comorbidities or major complications and comorbidities).

The Region A recovery auditor (RAC), which posted issues for 24 major diagnostic categories, did not respond to a request asking why they made the changes.

Connolly, the Region C RAC, posted two issues.


About the Author

Karen Long is the compliance product manager for DecisionHealth and oversees products that relate to fraud and abuse and HIPAA compliance for physician offices and home health agencies, and accreditation compliance for hospitals. In her almost four years at DecisionHealth, Karen also has been the compliance editor and a reporter for Home Health Line, nation's leading independent authority on home healthcare business, regulation and reimbursement.

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