Upcoding in medicare: where does it matter most?

Health Economics Review

Table 2 Error type distribution (%) in Part B

Fiscal Year	Incorrect coding	Insufficient documenta- tion	Medical necessity	No documen- tation	Other	Total
2010	2.95	6.52	0.36	0.65	0.01	10.49
2011	2.97	6.11	0.31	0.48	0.03	9.89
2012	2.70	6.88	0.38	0.45	0.09	10.50
2013	3.16	8.24	0.27	0.21	0.23	12.10
2014	3.12	8.66	0.22	0.48	0.22	12.70
2015	2.96	7.98	0.26	0.39	0.12	11.70
2016	2.76	6.69	0.35	0.31	0.09	10.20
2017	2.53	6.98	0.33	0.36	0.50	10.70
2018	2.58	5.27	0.27	0.37	0.11	8.60
2019	1.75	5.52	0.15	0.49	0.19	8.11

SOURCE: The reported improper payment rates in Part B IPPS in Medicare FFS Improper Payments Reports 2011 – 2020 [5].

ISSN: 2191-1991