Question

Assigning a diagnosis code that does not match patient documentation for the purpose or increasing reimbursement through the DRG system is known as:

Select one:
a. downcoding
b. bundling
c. upcoding
d. unbundling

Answer 1

Upcoding is the practice of assigning a diagnosis code that does not match the patient's documentation in order to increase reimbursement through the DRG system.

Step-by-step explanation:

The correct answer is c. upcoding.

Upcoding refers to the practice of assigning a diagnosis code that does not match the patient's documentation in order to increase reimbursement through the DRG (Diagnosis-Related Group) system. It involves using a more severe or expensive diagnosis code than is justified by the patient's actual condition. This practice is considered fraudulent and can result in penalties and legal consequences.