Downcoding and upcoding are not illegal practices, and medical assistants cannot be prosecuted for either practice.

Question

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Both downcoding and upcoding are illegal practices, and medical assistants can be prosecuted for participating in them. Downcoding involves billing for a lower level of service than was actually provided, while upcoding involves billing for a higher level of service than was actually provided. Both practices can result in insurance fraud and can have legal consequences. It is important for medical assistants to accurately and ethically code and bill for services provided.

Downcoding and Upcoding Are Not Illegal Practices, and Medical Assistants