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How Do CPT Codes Affect a Healthcare Fraud Case?

CPT and diagnostic codes are the basis of how medical bills are submitted today. This applies to Medicare, Medicaid as well as private insurance companies. It is not unusual to have disputes over the proper code. Depending on many factors there can be five or six different codes for an office visit.

It's important because of the role it plays in determining whether a service was properly billed. Whether or not a procedure is medically necessary provides even more grounds for a viable defense.

There are some unfortunate cases where a medical care provider bills for procedures that were not performed. "Those cases," says criminal defense attorney Mark Horwitz, "are probably going to be a matter of damage control."

To learn more about your rights, contact our office to speak to a healthcare fraud attorney at the Law Offices of Horwitz & Citro, P.A., today. You can contact us online or by phone at (407) 401-7224.