Medical device manufacturer THD America has agreed to pay $700,000 to settle allegations it knowingly caused physicians to use incorrect codes to obtain inflated reimbursement from Medicare and Medicaid.
The Justice Department alleged that between 2014 and 2017, physicians performing procedures using THD's hemorrhoid removal system called the Slide One Kit were required to bill the procedures using a temporary code, according to a Sept. 6 Justice Department news release.
Procedures with T-Codes are considered experimental, so reimbursement for the use of the kit was often denied, according to the release. To avoid denials and increase potential reimbursement, THD allegedly encouraged surgeons to improperly bill Medicare and Medicaid using the T-Code plus an additional CPT code or to bill for CPT codes other than the T-Code.
The claims resolved by the settlement are only allegations and there has been no determination of liability, according to the release.