Review of Texas Medicaid Inpatient Hospital Claims with Malnutrition Diagnosis

OBJECTIVE

Malnutrition can result from treatment of another condition, inadequate treatment or neglect, or general deterioration of a patient's health. Hospitals are allowed to bill for treatment of malnutrition on the basis of the severity of the condition (mild, moderate, or severe) and whether it affects patient care. Severe malnutrition is classified as a major complication or comorbidity (MCC). Adding an MCC to a claim can result in an increased payment by causing the claim to be coded in a higher diagnosis-related group. We will conduct statewide reviews to determine whether hospitals complied with Medicaid billing requirements when assigning severe malnutrition diagnosis codes to inpatient hospital claims.

TIMELINE

• November 9, 2021
  Announced
• November 26, 2024
  Complete

  Review of Texas Medicaid Inpatient Hospital Claims with Malnutrition Diagnosis has been marked as complete. Report Published

REPORT PUBLISHED

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