Medicare Advantage Enforcement is a focus area for the OIG this year, and we are learning from the four published audits so far, that the OIG audit can amount to a no good, very bad day. In general, these audits provide insight into areas of OIG focus including: a) acute care codes (ex: acute stroke) coded without any hospital visit; b) Codes that are diagnosed but not treated including (ex: embolism, vascular claudication and major depression) or codes that are otherwise not supported by the record. We did the hard work to sort through these audits – tune in for a concise update, quick tips and lessons learned.
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