Nov 16, 2018 - Health

Watchdogs are gunning for hospital coding

Surgical nurses look at a computer in a hospital.

Hospital nurses review electronic medical records. Photo: Jonathan Wiggs/The Boston Globe via Getty Images

The Centers for Medicare & Medicaid Services and HHS' Office of Inspector General will conduct a "two-part study," expected to be completed by 2020, that will scrutinize how hospitals overcharge Medicare — a practice known as upcoding.

Why it matters: Medicare paid hospitals $114 billion for inpatient stays in 2016, or about 17% of all Medicare payments. OIG has long criticized inpatient coding, a main artery for hospital finances, and this move foreshadows potentially bigger clawbacks on bad actors.

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