Will RAC’s review claims for evaluation and management services?

Yes, but the AAFP along with the AMA and multiple other medical specialties have sent a formal request to Medicare asking that this not include the level of service reported, due to the complexity of interpreting physician documentation to support the codes reported. The Centers for Medicare and Medicaid Services has stated, “The review of duplicate claims or E & M services that should be included in a global surgery were available for review during the RAC demonstration and will continue to be available for review. The review of the level of the visit of some E & M services was not included in the RAC demonstration. CMS will work closely with the American Medical Association and the physician community prior to any reviews being completed regarding the level of the visit and will provide notice to the physician community before the RAC’s are allowed to begin reviews of evaluation and management (E & M) services and the level of the visit.”