HCPro, JustCoding Inpatient - 2020 Issue 27 (July)
Healthcare News: Incorrect coding, MS-DRG assignment will cost hospital millions, says OIG
July 21st, 2020
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Article Overview
This news item reviews an OIG audit of Ohio State University Hospital and discusses how claim-level billing, coding, and MS-DRG assignment issues affected Medicare reimbursement during a defined audit period. It is relevant to hospital coders, CDI and compliance staff, auditors, and revenue integrity teams who track audit findings, extrapolated overpayment estimates, and related Medicare review processes.
Why This Topic Matters
It highlights how coding and claim-level documentation issues can lead to significant audit findings, repayment exposure, and broader compliance risk for hospitals.
What You Will Learn
- The general focus of an OIG audit involving Medicare inpatient and outpatient claims
- How billing, coding, and MS-DRG assignment issues can appear in audit findings
- What kinds of compliance and repayment concerns may arise from audit extrapolation
- How hospitals may respond to audit findings and OIG recommendations at a high level
Who Should Read This
- Hospital coders
- Inpatient coding staff
- CDI specialists
- Compliance officers
- Revenue integrity teams
- Healthcare auditors
- Hospital billing staff
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