George Breen and Bethany Hills Quoted in “CMS Releases Post-ICD-10 Claims Denial Reimbursement Metrics”


George B. Breen and Bethany J. Hills, Members of the Firm in the Health Care and Life Sciences practice, were quoted in RevCycleIntelligence, in “CMS Releases Post-ICD-10 Claims Denial Reimbursement Metrics,” by Jacqueline DiChiara.

Following is an excerpt:

There was a high chance of aggressive private and public audits because of ICD-10’s increased coding specificity for healthcare providers and organizations, said George B. Breen and Bethany J. Hills, both Members of Epstein Becker & Green (EBG), the week before ICD-10 went live.

“Under ICD-10, the number of diagnostic codes available for coding healthcare services will go from 13,000 to 68,000,” they said.

“With more specificity, increased enforcement will likely follow. Healthcare entities should anticipate – and be prepared to respond to – aggressive payor audits, both private and public, in addition to enforcement efforts focused on whether clinical documentation supports the ICD-10 code selected, and the potential for claims of false or fraudulent billing when they do not,” Breen and Hills added.

Mr. Breen and Ms. Hills previously discussed the likely results of ICD-10 implementation with RevCycleIntelligence in a September 2015 Q&A article.