Separating the components of a procedure and reporting them as billable codes with charges in order to increase reimbursement rates is known as what?

Question

Quizplus · Accepted Answer

Unbundling involves breaking down a complex procedure into separate components and billing each component as a separate procedure to increase reimbursement rates. This is considered fraudulent and illegal. Upcoding involves submitting a code for a more complex procedure than was actually performed. Bundling involves combining several services or procedures under a single code. Downcoding involves submitting a code for a less complex procedure than was actually performed.

Separating the Components of a Procedure and Reporting Them as Billable