What term refers to the inappropriate selection of a billing code that may lead to overpayment by a provider?

Study for the NAB Domain 2 Operations Test. Use flashcards and multiple choice questions, with hints and explanations. Get exam ready!

The term that refers to the inappropriate selection of a billing code that may lead to overpayment by a provider is upcoding. Upcoding occurs when a healthcare provider uses a billing code that reflects a higher level of service than what was actually provided to the patient. This practice is unethical as it can result in inflated claims and excessive reimbursements from insurance companies or government payers.

Upcoding can have serious implications for both healthcare providers and patients, as it may lead to legal consequences, investigations, and potential penalties for the provider. It highlights the importance of accurate coding in the billing process to ensure compliance and fair reimbursement for services rendered.

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