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Palmetto Health Baptist Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor

Palmetto Health Baptist Hospital (the Hospital), in Columbia, South Carolina, did not comply with Medicare requirements for billing Kwashiorkor on any of the 51 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have used codes for other forms of malnutrition. For 37 of the inpatient claims, correcting the diagnosis code resulted in no change in the payment. However, for the remaining 14 inpatient claims, the errors resulted in overpayments of $75,000. Hospital officials attributed these errors to the medical coding software program used to code the diagnoses.

Filed under: Center for Medicare and Medicaid Services