Upcoding Drug Tests: The QW Quandary


Monday, July 24, 2017
10-10:30 a.m. ET; 7-7:30 a.m. PT

Robin Zweifel, BS, MT(ASCP),
Panacea Healthcare Solutions

Janelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC;
Ronald Hirsch, MD, FACP, CHCQM; David Glaser, Esq.;
and Edward Roche, PhD, JD

A North Carolina hospital system recently agreed to pay the federal government $6.5 million to resolve allegations that it violated the False Claims Act by “upcoding” claims for urine drug tests in order to receive higher payment than allowed. At issue were two different payments for two different codes – G0431 and G0434 – and the use of the QW modifier.

Reporting on our lead story during the next edition of Monitor Mondays, at the suggestion from a RACmonitor reader, will be Robin Zweifel with Panacea Healthcare Solutions. Zweifel, who writes extensively on drug and laboratory compliance issues, is expected to get to the bottom of this alleged upcoding predicament that other facilities are encountering as well.  

The broadcast rundown also includes:

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.
  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO for Nancy Beckley and Associates, will have all the latest hot topics and the Monitor Mondays Listener Survey.
  • America’s Rural Health Report: Topic authority Janelle Ali-Dinar, vice president of rural health for MyGenetx, will report on saving healthcare for rural populations.
  • Ransomware Crisis: RACmonitor investigative reporter Edward Roche, founder and director of scientific intelligence for Barraclough NY LLC, will continuing his reporting on the global ransomware crisis facing America’s hospitals.
  • Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron will return with another example of a potentially troublesome issue that could pose a risk to your facility.

Register now for this readers-choice news broadcast coming your way on Monday, July 24, 2017 at 10 a.m. ET.

Monitor with us.™

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