I thought this would be an interesting article for our readers.
Physicians are improperly coding Medicare claims, and it’s costing billions of dollars, USA Today reports.
A new report found that in 2010, Medicare paid $6.7 billion in claims that weren’t coded correctly and lacked proper documentation, the report says. That billion-dollar figure accounts for 21 percent of Medicare’s budget for assessment and diagnostic visits.
More than 40 percent of the diagnostic and assessment claims were coded incorrectly. A number of physicians used “high-paying codes,” with 56 percent of the claims being improperly coded. Most of the time, the claims were up-coded and worked in the provider’s favor. About 15 percent of claims were mistakenly down-coded.
The U.S. deputy inspector general has made several recommendations to remedy the issue, including providing better quality training on coding and having contractors examine physicians’ billing.