DecisionHealth, DecisionHealth - 2013 Issue 12 (December)

Compliance: Nashville pediatrician learns the hard way that upcoding doesn’t pay

Advise your doctors that upcoding — even of ancillary services such as diagnostic tests — can land them in hot water. In a recent upcoding case, a Nashville pediatrician recently lost his practice and ended up excluded from federal health care programs with $1.6 million in damages and criminal restitution.

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