Free AAMA Certified Medical Assistant (CMA) Practice Question

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.