Joiner, Keith A.; Lin, Jianjing; Pantano, Juan - 2021
-for-service reimbursements, a small fraction of improper bills for hospitalization, and was not significantly correlated with diagnosis related … group (DRG) weights. Audit data does not discriminate between intentional (fraudulent) and unintentional upcoding. We … from 2013 – 2019, only 0.39% were for upcoding of hospital admissions, or 7.2% of all prosecutions for hospitals. Other …