Hospitals Point Finger At CMS For 'Upcoding' Problems

Law360, New York (September 26, 2012, 8:32 PM EDT) -- After the administration warned hospitals Monday not to use electronic health records to improperly “upcode” doctor and emergency room visits, hospitals hit back, arguing that the administration has repeatedly failed to better define those codes.

The American Hospital Association, in its response letter to Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder, argued that Medicare needs to clarify which codes should be used for which services before it can accuse hospitals of misusing those codes to get higher payments.

“We have made...
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