Healthcare News: OIG to audit inpatient reporting for severe malnutrition

February 15th, 2022

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers an Office of the Inspector General review of inpatient hospital billing related to severe malnutrition diagnosis reporting under Medicaid, and it references a prior Medicare audit for context. It is useful for hospital coding, compliance, and revenue cycle teams monitoring audit activity, diagnosis coding scrutiny, and payer-specific billing oversight.

Why This Topic Matters

It highlights audit attention on inpatient malnutrition reporting and the compliance risk associated with diagnosis coding on hospital claims. The article also helps readers understand the broader oversight environment for Medicaid and Medicare billing practices.

What You Will Learn

  • Why the OIG is reviewing inpatient hospital claims involving severe malnutrition
  • How a prior Medicare audit is being used as context for the current Medicaid review
  • What kinds of billing compliance issues were examined in the earlier audit
  • What types of organizations and coding teams may need to monitor this audit activity

Who Should Read This

  • Hospital coders
  • Inpatient CDI teams
  • Revenue cycle staff
  • Compliance officers
  • Health information management professionals
  • Auditors and billing managers

Codes Discussed

  • ICD-10-CM: E41
  • ICD-10-CM: E43

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