June 8, 2010

Nationwide Review of Medicare Part A Emergency Department Adjustments for Inpatient Psychiatric Facilities During Calendar Years 2006 & 2007 (A-01-09- 00504)

Hospital-based inpatient psychiatric facilities (IPF) received an estimated $1.7 million in overpayments in 2006 and 2007 because they miscoded the source of admissions. A federal review of 100 claims submitted by IPFs found that 75 had used incorrect source-of-admission codes for patients admitted to the IPF from another department. The overpayments were made on behalf of Medicare beneficiaries who had been admitted to the IPF upon discharge from the acute care section of the same hospital. The incorrect claims had used emergency department admission codes.