Upcoding in Medical Billing
Upcoding refers to the practice of assigning a higher-level code to a medical service than what was actually provided, resulting in a higher payment from the insurance company.
Upcoding in Medical Billing Explained
In medical billing, upcoding is considered fraudulent and can lead to penalties, audits, or legal consequences. It involves billing for a more expensive service than what was delivered to increase reimbursement.
For example, billing for a complex surgical procedure when only a minor procedure was performed constitutes upcoding.
Check acronyms and abbreviations in Medical billing glossary.
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