VAOIG Inspection of Allegations of Coding and Billing Irregularities, VA Medical Center, Kansas City, Missouri

Healthcare Inspection Review of Allegations of Coding and Billing Irregularities, VA Medical Center, Kansas City, Missouri 01/22/2010. This report reviewed allegations regarding a pattern of inappropriate medical coding and billing to increase third party insurance reimbursements at the Kansas City VA Medical Center. The allegation included two specific incidents: (1) the Medical Care Collection Fund Billing Department inappropriately added a Current Procedural Terminology “modifier 59” to the billing records for a patient receiving “Epoetin” injections, (2) and the Billing Department inappropriately billed for complications attributable to the patient’s participation in a voluntary research study. We were unable to substantiate the allegations and make no recommendations. VAOIG