Medicare Vulnerabilities: The Use of Diagnosis Codes in DME Claims

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76 pages
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Brief Executive Summary
The United States Senate Permanent Subcommittee on Investigations conducted an investigation into the fraud, waste and abuse in the Medicare program, this report focuses on the diagnosis codes on DME claims, as well as the effectiveness of CMS\342\200\231s use of the codes. The investigation uncovered that the rules governing the use of Diagnosis codes on DME claims were inconsistent, Medicare has not been effectively utilizing these codes in the claims review process, and some data was incorrect and outdated that was related to millions of claims.
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Related Hearings
Senate Committee on Homeland Security and Governmental Affairs, Permanent Subcommittee on Investigations, hearing on "Medicare Vulnerabilities: Payments For Claims Tied to Deceased Doctors," 110th Cong., S.Hrg. 110-721, (2008, July 9)
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