Two Automated, Five Medical Necessity Reviews

The Region D RAC, HDI, added two (2) new automated review issues for drug therapy, codes Q4095, J3488 and J3487, as well as five (5) new issues for Medical Necessity Review, last week. RAC Shadow’s lists include the relavent codes in the issue titles, something HDI typically leaves out of their posted issues.

Follow the links below to see the new issues here in our database:

HCPCS J3487: Zometa (Zoledronic Acid) Excessive Units

HCPCS Q4095, J3488: Reclast (Zoledronic Acid) Excessive Units

MSDRG 189: Pulmonary Edema and Respiratory Failure

MSDRG 434: Cirrhosis and Alcoholic Hepatitis without CC/MCC

?MSDRG 814: Reticuloendothelial and Immunity Disorders with MCC

?MSDRG 815: Reticuloendothelial and Immunity Disorders with CC

?MSDRG 816: Reticuloendothelial and Immunity Disorders without CC/MCC

To see searchable, sortable lists of all Approved Issues by Region, visit this page.