University Hospitals Case Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor
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University Hospitals Case Medical Center, in Cleveland, Ohio (the Hospital) did not comply with Medicare requirements for billing Kwashiorkor on any of the 95 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor, but should have used codes for other forms of malnutrition. For 76 of the inpatient claims, correcting the diagnosis code resulted in no change in the payment. However, for the remaining 19 inpatient claims, the errors resulted in overpayments of $118,000. Hospital officials attributed these errors to the medical coding software program used to code the diagnoses.
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Priority recommendations summarized.
FY 2016 Work Plan
OIG projects planned for 2016.
Significant OIG activities in 6-month increments.