Cahaba Announces Widespread Probe Review

on Thursday, 25 March 2010. All News Items

Cahaba GBA, Medicare Administrative Contractor (MAC) for Alabama, recently announced a widespread probe review that will affect Alabama hospitals.  Per the announcement, claims will be reviewed for medical necessity (e.g. compliance with CMS guidelines, contractor LCD'S, correct billing and coding).  Results of the probe reviews will be posted on Cahaba’s website and will help Cahaba determine providers’ educational needs.
The widespread probe review is for claims with DRG 641 Nutritional and Miscellaneous Metabolic Disorders w/o MCC for Bill Type 11X (Short Term Hospitals) and CAH's (Community Access Hospitals).  This will be a full claim review.
The complete Cahaba announcement is available at this link: Cahaba GBA Probe Notification DRG 641

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