Part B Insider (Multispecialty) Coding Alert
Unnecessary Services Lead to Criminal Charges for Cardiologist
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Plus: Check out new interventional cardiology specialty code.
An Ohio cardiologist is under fire for allegedly performing catheterizations, tests, stent insertions and other procedures that weren’t medically necessary to the tune of $7.2 million. The 55-year-old doctor was indicted on 16 counts of federal charges, including health care fraud and making false statements stemming from the charges.
“The charges in this case are deeply troubling,” said U.S. Attorney Steven M. Dettelbach in an Aug. 21 statement. “Inflating Medicare billings alone would be bad enough. Falsifying cardiac care records, making an unnecessary referral for open heart surgery and performing needless and sometimes invasive heart tests and procedures is inconsistent with not only federal law but a doctor’s basic duty to his patients.”
The doctor is accused of upcoding his services, performing unnecessary nuclear stress tests, falsifying test results to justify catheterizations, performing stent insertions on patients who did not have symptoms of a blockage, and other charges that led to the indictment. He is accused of overcharging by $7.2 million and actually collecting $1.5 million.
To read more about the case, visit www.justice.gov/usao/ohn/news/2014/21augpersaud.html.
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