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Frequently Asked Questions

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When billing for routine clinical research study-related services rendered to a healthy control group volunteer, are there any financial implications to placing the Z00.6 diagnosis code in the secondary position, while placing a disease diagnosis code in

Yes. When submitting a claim for routine clinical research study-related services to a federal payer, reporting a disease diagnosis on the claim, when no such medical condition exists, may be construed as a false claim, as the patient’s medical condition is being inaccurately represented. Submitting a false claim may result in significant fines of up to three times the amount of damages sustained by the government payer, plus up to $11,000 per false claim submitted.

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