Part B Insider (Multispecialty) Coding Alert
Texas Doctor Faces Up to 10 Years in Jail for Changing Dx Codes
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Plus: Patient insists on service but refuses to sign ABN? Get a witness.
Fraudulent medical coding doesn’t always involve CPT or supply codes. You can face hard time for changing diagnoses as well.
That’s the lesson that a Texas physician learned this week after being charged with seven counts of health care fraud. Between 2010 and 2013, the general practitioner is alleged to have added, changed, deleted, and incorrectly sequenced diagnosis codes “in a way that did not reflect the actual diagnoses and conditions of the patients,” an April 23 Department of Justice news release said. These ICD-9 code changes resulted in the doctor submitting false claims of over $1.1 million to Medicare and Medicaid, the DOJ reports.
The physician faces up to ten years in prison if he is found guilty of the accusations. To read more about the case, visit www.justice.gov/usao/txe/News/2013/edtx-hcf-mahmood-042313.html.
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