OIG Audit of Medicare Advantage High-Risk Diagnosis Codes

Miscoded diagnoses may cause CMS to pay Medicare Advantage (MA) organizations improper amounts. To emphasize the need for accurate coding to avoid increased risk-adjusted payments, the OIG is conducting a nationwide audit to determine whether these diagnosis codes, as submitted by MA organizations to CMS for use in CMS's risk-adjustment program, complied with Federal requirements. Read more about this new work plan item.

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