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Audit (A-03-10-00013)

Review of Medicare Acute Care Inpatient Same-Day Readmissions at University of Pittsburgh Medical Center Presbyterian Shadyside Hospital

Executive Summary

The University of Pittsburgh Medical Center Presbyterian Shadyside Hospital (Presbyterian Shadyside) did not always bill same-day readmissions in accordance with Federal requirements. For 7 of the 27 same-day readmissions in our review, Presbyterian Shadyside incorrectly billed the second admission as a separate inpatient stay instead of a continuous stay based on the first admission, resulting in $27,000 in overpayments. These overpayments occurred because Presbyterian Shadyside did not have adequate training to review same-day readmissions and prevent incorrect billings.

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