CodingPregunta 28 de 100
Upcoding, which is prohibited, refers to:
a.Reporting a lower-level service than was documented
b.Reporting a higher-level or more complex service than was actually documented or performed
c.Bundling two codes into one appropriately
d.Using the correct modifier on a claim
Explicación
Upcoding is the improper practice of assigning a code that reflects a more severe diagnosis or more expensive service than the documentation supports, in order to obtain higher payment. It is considered fraudulent and can trigger penalties. Coders must assign codes strictly according to the medical record.
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