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Audit (A-01-10-00500)

01-13-2011
Review of TrailBlazer Health Enterprises, LLC Payments for Inpatient Rehabilitation Facility Claims Billed with Patient Status Code 05 for Calendar Year 2007

Executive Summary

Inpatient rehabilitation facilities (IRF) incorrectly coded 24 of the 41 claims that we reviewed with patient status code 05. Because IRFs did not use the appropriate transfer codes on these claims, TrailBlazer made $162,000 in overpayments for miscoded transfers to 10 IRFs in calendar year 2007.

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