This is the "Health Care Fraud and Medical Record Coding" page of the "Elder Law Research" guide.
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Last Updated: Sep 5, 2017 URL: http://libguides.law.usd.edu/elderlaw Print Guide RSS Updates

Health Care Fraud and Medical Record Coding Print Page
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Books on Health Care Fraud in the USD Law Library

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Health Care Fraud and Abuse - Hoyt W. Torras
Call Number: LOWER LEVEL - CIRCULATING COLLECTION KF3605 .T67 2003
ISBN: 1579473539
Publication Date: 2002-12-01

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Health Care Fraud and Abuse - Aspen Health Law and Compliance Center Staff
Call Number: LOWER LEVEL - CIRCULATING COLLECTION KF3605 .H425 1998
ISBN: 0834211599
Publication Date: 1998-03-09

 

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.

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Deciphering Codes: Fraud & Abuse for Coders and Coding Insight for Healthcare Lawyers - Brad Ericson & Renee Dustman, eds.
ISBN: 9780327175230
Publication Date: 2010 Washington, D.C. : American Health Lawyers Association
Project Leaders: Rhonda Buckholtz & Robert A. Pelaia

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