What is the practice of coding a procedure or service at a higher level than was actually performed in order to receive higher reimbursement?
Modifier usage
Bundling
Upcoding
Downcoding
Upcoding is the practice of using a code that inaccurately represents a higher level of service than what was actually provided in order to receive higher reimbursement. This is illegal and unethical. Downcoding, on the other hand, involves coding a procedure or service at a lower level than was actually performed. Modifier usage and bundling/unbundling refer to other aspects of coding but are not relevant to the definition of upcoding.
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