DEAR DR. ROACH: When I have appointments with my physicians (at our local, highly rated academic health system), they no longer do a physical exam. But in the after-visit note, there is a documented ...

Upcoding for inpatient hospital stays continues to be a problem, with a recent RAND study showing that the cost of upcoding totals around $14.6 billion. That shakes out to around $5.8 billion in ...

Andrew S. Oseran, MD, MBA, MSc, hypothesizes that higher Medicare Advantage (MA) risk scores may result from either a more accurate capture of beneficiaries' comorbidities or inappropriate "upcoding" ...

Brigham and Women's nurses postponed the Oct. 14 strike to vote on a final offer. See the pay, insurance, and staffing terms, and what patients face. Parents Should Check Amazon Bath Seats and ...

Diagnosis-based payment systems can create incentives to upcode patients to a higher level of severity to increase payment. In some instances, upcoding can be a form of fraud if providers code ...