Review of Anesthesia, Pharmacy and Supply Services Incident to Other Outpatient Diagnostic Services Processed By Associated Hospital Services

EXECUTIVE SUMMARY:

This report points out that many hospitals serviced by Associated Hospital Services (AHS) did not establish adequate internal controls to ensure that claims for anesthesia, pharmacy and medical supply services used incident to other outpatient diagnostic services were coded in accordance with Medicare requirements.  This was particularly true of providers of cardiac catheterization services.  In this regard, hospitals, that rendered cardiac catheterizations, incorrectly coded pharmacy, anesthesia and medical supplies using general revenue codes instead of the specific revenue codes required when billing for services incident to other outpatient diagnostic services.  As a result, the hospitals overcharged an estimated $518,000 on claims submitted to AHS.

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