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New York Hospital Queens Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor

New York Hospital Queens, in Flushing New York, did not comply with Medicare requirements for billing Kwashiorkor on any of the 64 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have used either a code for another form of malnutrition or no malnutrition code at all. For 47 of the inpatient claims, correcting the diagnosis code resulted in no change in the payment. However, for the remaining 17 inpatient claims, the errors resulted in overpayments of $90,000. Hospital officials attributed these errors to Hospital personnel not following established billing procedures.

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201