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Cornerstone Hospital of Bossier City Incorrectly Billed Medicare Inpatient Claims with Kwashiorkor

Cornerstone Hospital of Bossier City (The Hospital), in Bossier City, Louisiana, did not comply with Medicare requirements for billing Kwashiorkor on any of the 73 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have billed for other forms of malnutrition. For 25 of the inpatient claims, substituting a more appropriate diagnosis code produced no change in the diagnosis-related group or payment amount. However, for the remaining 48 inpatient claims, the errors resulted in overpayments of $322,000. The Hospital believes that all claims identified by the Office of Inspector General were appropriately submitted for payment.

Filed under: Center for Medicare and Medicaid Services