This case study examines a provider who overcharged for a leg brace beyond reimbursement benchmarks, with manual review identified repeated overbilling and financial loss. It highlights how AI-enabled integration transforms retrospective workflows and the evolving role of the Clinical Information Professional.

ICD-10-CM and ICD-10-PCS codes updated for services provided on October 1, 2021 thru September 30, 2022. Each year the World Health...