Daniel Crespin
Documents & Publications
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Upcoding Linked to up to Two-Thirds of Growth in Highest-Intensity Hospital Discharges in Five States, 2011–19
Diagnosis-based payment systems can create incentives to upcode patients to a higher level of severity to increase payment. In some instances, upcoding can be a form of fraud if providers code patients to a higher complexity than is appropriate, whereas in other instances, upcoding can accurately reflect patient acuity. We… |