Sepsis Upcoding Is Costing Health Plans a Fortune

Stop Paying Too Much for Sepsis

Sepsis is one of the most frequently diagnosed DRGs. It’s also one of the most expensive. The condition has been a hotly contested issue among providers, payors, and regulatory agencies for decades, and remains a continued source of disagreement today. Insufficient regulatory action, the absence of a universally accepted definition for sepsis and the potential for huge financial rewards make sepsis highly vulnerable to upcoding schemes and other attempts to game the system. By understanding the numbers associated with sepsis, we can all better work together to tackle this issue in a more collaborative and equitable way.

Download the Sepsis infographic here.

Read more on Sepsis in our blog – Sepsis Coding Issues Support Enhanced Payment Integrity.