Surfacing High-Risk Diagnosis Codes: Leveraging OIG’s Methodology to Ensure Integrity in Submissions

Aired: October 11, 2022

Sponsored by Episource

Since 2021, the Office of Inspector General has employed a new audit methodology to surface non-compliant diagnosis codes, by scrutinizing particular fact patterns in coding data that correlate with improper documentation. It refers to these fact patterns as “Selected High-Risk Diagnosis Codes”. During this webinar, William Schweitzer and Deborah Curry discussed the recent literature from the Office of Inspector General focusing on integrity in diagnosis code submissions, impacts on coding in Medicare Advantage and more.

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