Câu 23: CFE - Financial Transactions and Fraud Schemes: Certified Fraud Examiner - Financial Transactions and Fraud Schemes
A particular back surgery contains two basic components (an incision and muscle repair), but it is supposed to be billed using a single procedure code. Heather performs this back surgery on a patient and submits a claim using three codes: one for the full procedure, one for the incision, and one for muscle repair. Whi…
Nội dung câu hỏi
A particular back surgery contains two basic components (an incision and muscle repair), but it is supposed to be billed using a single procedure code. Heather performs this back surgery on a patient and submits a claim using three codes: one for the full procedure, one for the incision, and one for muscle repair. Which scheme BEST describes Heather’s actions?
Các lựa chọn
Đáp án được giữ gọn theo nhãn A, B, C, D trong phần bình chọn tương tác.
- A. Unnecessary services
- B. Upcoding — đáp án hiện tại
- C. Over-utilization
- D. Unbundling
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