Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out is an example of ____.
A) Reporting services that were not performed
B) Reporting services at a higher level than was carried out
C) Performing procedures not related to the patient's condition
D) Billing separately for services that are bundled in a single procedure code
E) Reporting the same service twice

Question

Quizplus · Accepted Answer

This is an example of "upcoding," where a healthcare provider bills for a higher level of services than was actually provided. In this case, billing for a moderate level evaluation and management service when only a simple procedure was performed inflates the level of care reported.

Billing for a Moderate Level Evaluation and Management Service When