3 labs to pay $2.45M to settle code manipulation allegations

Three laboratories have agreed to pay $2.45 million to resolve allegations they submitted claims containing manipulated diagnosis codes to Medicare and Medicaid. 

Vista Clinical Diagnostics, Access Dermpath and Advanced Clinical Laboratories allegedly billed for clinical laboratory services using diagnosis codes that were generated by a macro and inserted into beneficiaries’ reimbursement submissions, according to a July 11 Justice Department news release. 

The code manipulation allegedly occurred between 2017 and 2021, according to the release. 

The settlement includes claims brought under the False Claims Act's whistleblower provisions. The whistleblower, a former Vista Clinical Diagnostics employee, will receive more than $440,000 of the proceeds from the settlement. 



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