Insurer Granted Judgment In $650,000 Fraudulent Billing Suit For ‘Reckless’ Coding

Mealey's (February 1, 2023, 9:37 AM EST) -- DETROIT — A Michigan federal judge granted summary judgment to an insurer in a fraudulent billing suit against an ambulatory surgery center alleging that improper current procedural technology (CPT) coding resulted in the surgery center’s receiving an overpayment of $652,557, finding that the surgery center acted “reckless[ly]” by using surgical CPT codes for a nonsurgical procedure and that it was “unconscionable” for the surgery center to keep payment for services not provided....