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Center for Public Integrity: Upcoding, Billing Abuse on the Rise

An investigation by the Center for Public Integrity found medical billing abuse and upcoding may be on the rise as medical professionals have billed an additional $11 billion over the last decade, according to The Washington Post.

The investigation looked at 362 million claims from 2001 to 2010 and discovered more physicians billed Medicare for higher-paying codes for office visits and reduced lower-paying codes. Hospitals also sharply increased their use of highest codes for emergency room visits.

Medical professional attribute the higher codes to an increase in older and sicker patients. However, the Center for Public Integrity's data show no increase in the average age of Medicare beneficiaries during the decade.

Rather, the center attributes the shifter to higher codes as an increase in upcoding by healthcare systems to bill Medicare for more expensive services than were actually delivered.

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