upcode

upcode

(ŭp′kōd″)
To assign a higher billing code to a patient visit than is justified by common practice or law.

upcode,

n use of a procedure code that reflects a higher-intensity service than would normally be used for the services delivered.
References in periodicals archive ?
The potential reasons to lower the severity of the diagnosis does create some tension with the incentive to upcode because the APR-DRG and DRG are related.
Since I wasn't going to upcode, what the department's directive meant for me on a practical level was that I had to see more patients.
The federal government has been taking a closer look at coding, with the concern that electronic health records are making it easier to upcode.
L'operation touchera, dans une phase d'essai, les nouveaux registres du commerce, dans leur forme actuelle, qui seront codes a travers la solution technologique UPCODE (une puce electronique) durant les trois derniers mois de l'annee en cours a precise le ministre.
If a clinician chooses to upcode a child from the unreimbursable parent-child relational problem to a potentially reimbursable diagnosis such as oppositional defiant disorder, the potential harms of labeling and stigma exist for the child even if the client's parent willingly agrees to the misrepresentation.
Suppliers and nursing homes can upcode bills for more expensive (e.
Users also may download to their mobile phone an application developed by GossRSVP and Upcode Ltd.
If probability of detection is low, profit maximizing physicians can be expected to choose higher reimbursement codes or upcode on the margin.
Larger hospitals and teaching hospitals were found to be associated with less upcoding, perhaps because the financial pressure to upcode is less in these hospitals or the reputation risk from negative publicity is greater.
Doctors who spend a lot of time with a patient usually upcode a visit to 99215 or 99205.
Health care providers such as hospitals and doctors who bill for services not rendered or who upcode in order to receive a higher billing may find themselves facing prosecution.
With upper respiratory infections, the physicians who could be in trouble are those who routinely prescribe antibiotics, or routinely order labs and x-rays, or inappropriately upcode for the office visit.