With the expanded legal risks for clinicians and patients seeking abortion care after Dobbs v Jackson Women’s Health Organization,¹ the prevalence of abortion miscoding—coding a surgical or chemical abortion as a miscarriage—is likely to increase. While some physicians may intentionally miscode to provide abortion services while avoiding criminal liability, unintentional miscoding may occur when patients conceal self-managed abortions but require follow-up care. Both well-intentioned and unintentional miscoding carry legal risks that clinicians should consider when engaging in this practice.

Intentional miscoding to bypass civil and criminal penalties may raise concerns by hospital systems around False Claims Act (FCA)² liability, especially with Medicaid patients. Additionally, violating abortion reporting requirements is another potential risk, although penalties may be less stringent for now. This Viewpoint considers the legal risks that physicians may incur when miscoding in patients’ medical records to conceal an abortion, beyond the obvious issue of running afoul of statutes criminalizing the provision of abortion services or aiding and abetting an abortion.