News: OIG announces inpatient hospital billing, coding study

CDI Strategies - Volume 12, Issue 58

CMS and the Office of Inspector General (OIG) will conduct a two-part study to assess inpatient hospital billing due to unspecified upcoding in hospital billing—either accidentally or intentionally reporting higher severity codes than supported by documentation to increase payment, according to the OIG.

The first part of the study will analyze Medicare claims data to determine how inpatient hospital billing and coding has changed over time and describe how it has varied among hospitals, JustCoding reported.

The study will then 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, says the announcement. This study is expected to be published in 2020, according to the OIG.

According to the OIG, in 2016 hospitals billed Medicare $114 billion for inpatient hospital stays, which accounted for 17% of all Medicare payments.

Editor’s note: This article originally appeared in JustCoding. To read the OIG announcement, click here. To read about other OIG news, click here.

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