Submitting OIG:
Report Description:
Cornerstone Hospital of Southwest Louisiana (the Hospital) in Sulphur, Louisiana, did not comply with Medicare requirements for billing Kwashiorkor on any of the 52 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have used codes for other forms of malnutrition. The 52 inpatient claims that were coded incorrectly resulted in overpayments of $343,000. Hospital officials believe that all claims identified by OIG were appropriately submitted for payment.
Date Issued:
Wednesday, July 6, 2016
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-03-15-00008
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
Cornerstone Hospital of Southwest Louisiana
Location(s):
LA
United StatesType of Report:
Audit
Questioned Costs:
$343,365
Funds for Better Use:
$0
Number of Recommendations:
2
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