Question

Which one of the following choices occurs when a procedure that's coded and reported is lower in reimbursement than the code that should have been reported?A) Unbundling

B) Upcoding
C) Downcoding
D) Undercoding

Answer 1

Downcoding occurs when a procedure that's coded and reported is lower in reimbursement than the code that should have been reported.

Step-by-step explanation:

Downcoding occurs when a procedure that's coded and reported is lower in reimbursement than the code that should have been reported. This happens when a medical professional or coder submits a code that doesn't accurately reflect the complexity or intensity of the procedure performed. For example, if a procedure that should have been coded as a level 4 is coded as a level 3, it will result in lower reimbursement.