UPCODING

Upcoding

Upcoding

Concept of UpCoding

Medical providers use a standardized system of numerical codes for patient services, required by Medicare, Medicaid, and other Government programs. In this way, insurers and the Government do not have to decode what services were provided from myriad records or from thousands of different types of coding or billing systems.

Discussion

In a hospital setting or other specialized area of medicine, there are many more applicable codes than those that appear pre-printed on the bill from your outpatient visit to the family doctor. It can be a legitimate process but some hospital misuse this procedure. Misuse of these standardized codes ...