Government Targets EHR-Generated Upcoding

By: Vanessa Reynolds

In response to reports of Medicare overbilling by providers, as recently described in The Center for Public Integrity’s “Cracking the Codes” series, the National Coordinator for Health Information Technology (NCHIT) is undertaking an investigation of the allegations. Among the issues raised was the suggestion that billing erros and abuses are increasing as more providers adopt electronic health records. NCHIT is concerned that EHR systems may trigger upcoding by allowing the provider to cut and paste records from prior encounters, a practice known as “cloning.” Also under review are software functions that prompt providers to inflate billing codes.

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