Coding Undocumented Items Considered Fraudulent

Article Overview

This article explains why undocumented or mismatched diagnosis coding can create fraud and audit exposure, especially in gastrointestinal and colonoscopy claims. It is aimed at coders, compliance staff, and GI practices that need to understand the general relationship between documentation, diagnosis coding, and coverage review. The article also touches on Medicare attention to screening-versus-diagnostic colonoscopy claims and the broader importance of supporting claim submissions with the medical record.