Asked by Veronica Beltran on Jun 28, 2024

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_____________ is illegal because it reports a higher level of service or more severe condition than is true of the encounter with the patient.

A) Upcoding
B) Unbundling
C) Double billing
D) HIPAA

Upcoding

Using a code on a claim form that indicates a higher level of service, or a more severe aspect of disease or injury, than that which was actual and true.

  • Understand the economic and judicial consequences associated with coding, encompassing fraud and misuse.
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CS
Constance ShermanJun 29, 2024
Final Answer :
A
Explanation :
Upcoding involves reporting a higher level of service or a more severe condition than was actually documented in the patient's medical records. This is considered fraud and is illegal. Unbundling refers to billing for individual services separately instead of using a comprehensive code that covers all the services. Double billing is billing for the same service twice, which is also fraudulent. HIPAA is related to patient privacy and confidentiality and does not pertain to billing practices.