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Medicare Vulnerabilities: The Use of Diagnosis Codes in DME Claims
Senate Committee on Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations
Senate Committee on Homeland Security and Governmental Affairs
Permanent Subcommittee on Investigations
Abstract
From the Senate Committee on Homeland Security and Governmental Affairs, the Permanent Subcommittee on Investigations conducted an investigation into fraud, waste, and abuse in the Medicare program. This Minority Staff report focuses on the diagnosis codes on durable medical equipment (DME) claims, as well as the effectiveness of the Centers for Medicare & Medicaid Services (CMS) use of the codes. The investigation uncovered inconsistent rules governing the use of Diagnosis codes on DME claims, that Medicare has not been effectively utilizing these codes in the claims review process, and millions of claims had incorrect and outdated data.
Date
2008-09-24
Document Type
Senate Minority Staff Report
Serial Number
Document Length
76 pages
Congress
110
Relation
DOI
Keywords
Staff Reports
PAP Major Code
3: Health
PAP Minor Code
324: Medical Liability, Fraud and Abuse