Can False Codes Be Used to Submit a Medicare Claim?
Full Question:
Can a DME company submit diagnosis to medicare for payment for orthotic splints by using diagnosis codes that medicare will pay for instead of the diagnosis submitted by therapists?
06/27/2009 |
Category: Medicaid |
State: Florida |
#17218
Answer:
A diagnosis code that is submitted while knowing it to be false, and used to induce payment of a claim, may constitute Medicare fraud. "Code jamming" is a term used to describe a type of medicare fraud involving using fake diagnostic codes to fool the federal government into paying a claim.
