Kwashiorkor is a form of severe protein malnutrition that mostly affects children in famine-stricken areas and developing countries. Kwashiorkor is not common in the U.S., but Medicare still provides reimbursement for its treatment.
Palmetto Health Baptist is the third hospital this year the OIG has found to have erroneous kwashiorkor claims. The other two were Mercy Medical Center in Des Moines, Iowa, and Christus Saint Vincent Regional Medical Center in Santa Fe, N.M.
Overall, the OIG found 51 claims at Palmetto Health Baptist that were incorrectly billed using the diagnosis code for kwashiorkor when a different code for less payment should’ve been used. The hospital agreed with the OIG’s findings, but officials argued that two of the claims resulted in no payment difference. However, the agency stood by its findings.
More Articles on Hospitals and Overpayments:
Government Cracks Down on Dual Eligible Overpayments to Hospitals
UMass Memorial, Baylor All Saints Cited for Medicare Overpayments
OIG: Medical University of South Carolina to Refund $264k
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.