Medicare Compliance & Reimbursement

Industry Notes:

DOJ Case Illustrates the Woes of Upcoding

Shoot for necessity and accuracy when billing for the services you render. Upcoding sits atop the HHS Office of Inspector General’s hitlist. Sometimes upcoding occurs because of documentation errors or the EHR identifies the service under a higher-paying code. But in one North Carolina case, a provider knowingly upcoded to the tune of $6.5 million. The Department of Justice’s (DOJ) [...]
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