Optum360 coding books logo
    Contact Us   (7 a.m.–7 p.m. CST)
  Home > Coding Central Articles > Coding Central Articles  
Coding Central
Coding Central Home
Inside Track to ICD-10
Coding Central Articles
Code This!
Case Studies
Chargemaster Corner

Articles for:
January 25, 2018

Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More

New and Revised Vaccine Codes Added to 2018 CPT Code Book

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 201... Learn More

OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More

View Article Archive

To subscribe, paste this link into your preferred feedreader, or click on one of the buttons below:

Medical Coding News Archives

RAC Recoupment Causes Confusion

May 13, 2010:

Providers are noting a number of issues with this process, including the use of incorrect remittance advice remark codes and recovering amounts that differ from those requested in the overpayment demand letter.

Officials with the Centers for Medicare and Medicaid Services acknowledge some problems and are working with the RACs to remedy any and all issues. They have asked for patience with this matter due to the implementation of a new system that still has a few remaining glitches to be mitigated. Additionally, CMS is asking providers to ask their RAC to clarify or correct any errors associated with a recoupment.

When a claim is adjusted due to a RAC overpayment, the remittance advice should indicate remittance advice remark code (RARC) N432 (Adjustment based on a recovery audit). CMS created this code to identify RAC-adjusted claims; however, the agency states that N432 is at times being superseded by RARC N469 Alert: Claim/service(s) subject to appeal process, see section 935 of Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which is section 935 Limitation on Recoupment code. CMS is actively working to correct this problem in the system.

In the meantime, providers should carefully match demand letters to any offsets that appear on the RAs. All demand letters include an internal control number (ICN) or document control number (DCN). The ICN or DCN is also indicated on the RA so that it may be linked back to the demand letter. If it is necessary to communicate to the RAC, be sure to include the ICN or DCN.

Deborah C. Hall Clinical/Technical Editor

Key Terms: Recovery Audit Contractors, RAC, overpayments, recoupment, remittance advice


Sign in to
Your Account
Forgot your username?
Forgot your password?
Don't have an account?
It's easy to create one.
Promo code

Have a promotional source code? Enter it here:

What is this?