Explain the difference between upcoding and downcoding

What will be an ideal response?

Answer: Services are upcoded when documentation in the medical record does NOT support the level of service; the code is for a procedure that is more involved than was actually performed. Downcoding refers to the use of a procedure code that is for a service that is less involved than that stated in the medical record.

Health Professions

You might also like to view...

Endocrine gland activity is regulated by the:

a. Hypothalamus b. Thalamus c. Subthalamus d. Epithalamus

Health Professions

Which of the following terms means surgical fixation of joint, eventually resulting in intentional bone fusion?

a. anastomosis b. ankylosis c. arthrodesis d. arthroplasty

Health Professions