According to the OIG, the hospital billed Medicare for kwashiorkor, a form of severe protein malnutrition that typically affects children in famine-stricken areas and developing countries.
The OIG said JeffersonHospital submitted 46 claims that used the kwashiorkor diagnosis code when a different malnutrition code should have been used. The errors resulted in $185,488 in overpayments to the hospital.
The OIG’s audit covered 46 inpatient claims that the hospital submitted from Jan. 1, 2010, through Dec. 31, 2013.
Based on its findings, the OIG recommended the hospital refund overpayments in full to Medicare and implement controls to ensure future compliance with Medicare malnutrition billing requirements.
JeffersonHospital concurred with the OIG’s findings and recommendations.
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