Complaint
HL-2026-04827
Upcoding on imaging services
Complaint text
Received Nov 27, 12:05 PM via Email · Facility Los Angeles NDC · ZIP 90021
Audit run against OWCP claims identified 27 instances where MRI services were billed at a higher CPT level than clinical notes support.
AI summary
Generated from the complaint narrative.
Automated audit flags upcoded MRI billings on 27 OWCP claimants at one clinic.
Similar prior complaints
Matched by program area and narrative similarity.
HL-2026-04811
Provider billing for unrendered PT sessionsHL-2026-04812
Upcoding on imaging servicesHL-2026-04826
Provider billing for unrendered PT sessions AI classification
Suggested by the intake model.
Suggested area
Health Care Provider Fraud
Confidence61%
Priority score34
Assignment
Assigned analyst
R. Chen
ChannelEmail
Facility
Los Angeles NDC
ZIP
90021