DEAR DR. ROACH: When I have appointments with my physicians (at our local, highly rated academic health system), they no longer do a physical exam. But in the after-visit note, there is a documented ...

Andrew S. Oseran, MD, MBA, MSc, hypothesizes that higher Medicare Advantage (MA) risk scores may result from either a more accurate capture of beneficiaries' comorbidities or inappropriate "upcoding" ...

In five states over nearly a decade, hospitals have increased how frequently they document patients as needing the highest intensity care, which has led to hospitals receiving billions in extra ...

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 ...