Books on Health Care Fraud in the USD Law Library
Resources on Medical Record Coding
As the Senior Health Resource Center suggests, "Health care fraud may involve billing for services that were not provided. A health care provider may intentionally assign the wrong code to a procedure, using a code for a different procedure that is reimbursed at a higher amount." This common type of fraud is often referred to as up-coding.
To establish health care fraud and financial abuse of elders in regards to health care, a legal practitioner must develop some familiarity of medical records, medical billing, and the coding on which records and billing are based.
The Centers for Disease Control & Prevention (CDC) provides a general introduction to the coding classification system and links to additional resources.