“CMS’s failure over 7 years to fix a known Medicare billing code error may have cost taxpayers $102 million in payment to hospitals.”
“Despite being relatively rare in the United States, “Medicare paid hospitals $2.5 billion for claims that included a diagnosis code for Kwashiorkor” from 2006 through 2014, according to the probe by the Office of the Inspector General at the U.S. Health and Human Services Department…”
“But it turned out that the same code number — 260 — was assigned to both Kwashiorkor and to less severe forms of malnutritions on one list that was part of the international coding classification that is a key tool for billing…”
“In 2006, about 11,000 Medicare claims included diagnosis code 260. Over the next three years, after CMS implemented the new system, “the number of claims that included diagnosis code 260 rose to approximately 45,000” for 2009…”
Source: Top federal health agency failed to fix billing problem for years — and may have cost taxpayers up to $102 million – By Dan Mangan, December 5, 2017, CNBC. Read the full article here.
