The switch to ICD-10 was expected to make upcoding in medical billing harder. First, some background: The World Health Organization is the public health arm of the United Nations. Since 1948, WHO has been responsible for updating the International Classification of Diseases (ICD), a worldwide system for collecting, processing, classifying and processing statistics about diseases. The most recent version of the ICD is ICD-10, or tenth edition, which WHO published in 1999. How ICD Codes Are Used … [Read more...]
OIG Work Plan Provides Strong Clues on Trends in Healthcare Fraud
The U.S. Department of Health and Human Services (HHS) is the federal agency that runs the Medicare and Medicaid programs. Within the Department, the Office of the Inspector General (OIG) is charged with preventing fraud on the Medicare and Medicaid programs, and identifying and holding accountable those that have abused their role as healthcare providers. OIG conducts audits, investigations, and evaluations of Medicare and Medicaid, and works closely with attorneys within HHS and at the U.S. … [Read more...]
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