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.

 

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