At Verisys, we are always looking for better ways to make our customers successful. We are here for you as your trusted advisor with a focus on your unique definition of success. Keep us in the loop so we can be a valuable member of your team.

  • Open Support Tickets
  • View Open Tickets
  • Chat with a Client Advisor
  • View Knowledge-base Articles

Let's Talk

Call 888-837-4797 or complete the form below.

Fields marked with an * are required

Northside Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition

January 18, 2017

“Northside Medical Center (The Hospital), in Youngstown, Ohio complied with Medicare billing requirements for diagnosis codes 261 and 262 for 2 of the 100 claims that were reviewed,” according to an audit conducted by the Office of Inspector General. However, the Hospital did not comply with Medicare billing requirements for the remaining 98 claims.

For two of these claims, the medical record documentation supported a secondary diagnosis code other than 261 or 262, but the error resulted in no change to the diagnosis-related group or payment. For the remaining 96 claims, the billing errors resulted in overpayments of $464,000.

These errors occurred because the Hospital used diagnosis code 261 or 262 when it should have used codes for other forms of malnutrition or no malnutrition diagnosis code at all. On the basis of our sample results, we estimated that the Hospital received overpayments of at least $1.28 million over 2 and a half years.

Copies can also be obtained by contacting the Office of Public Affairs at

Download the complete report.

Susen Sawatzki Written by Susen Sawatzki
Healthcare Industry Expert
Muse. Writer. Publisher. Producer. Creator of Inspiring Narratives.
Connect with Susen on LinkedIn