General Question for the Week of November 26, 2018

General Compliance Question of the Week

Question:

Has CMS analyzed the most frequent billing problems on the inpatient side of Medicare?

Answer:

The Centers for Medicare & Medicaid Services and the Office of Inspector General (OIG) have identified problems with upcoding in hospital billing—that is, the practice of miscoding or over-coding to increase payment. The OIG will be conducting a two-part study over the next two years to assess inpatient hospital billing and use the results of this analysis to target certain hospitals or codes for a medical review to determine the extent to which the hospitals billed incorrect codes.

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.