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4-1-1 on Comp: Upcoding and Workers' Compensation

  • 04/24/18
  • Bruce Burk


Upcoding is the practice of a medical provider billing a medical event on a more expensive code than the service that the provider actually gave to the patient. Upcoding can occur in four different forms. Service Based Upcoding Service based upcoding refers to the practice of billing for a much more expensive procedure, such as surgery, when the provider actually performed a much cheaper procedure. Location Based Upcoding Location based upcoding is when a medical provider bills for a ...

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