Addressing Upcoding and Ethical Decision Making
Major Categories of Health Care Fraud and Abuse Category of Health Care Fraud and Abuse Description of Category and Example from Authoritative Source* Upcoding Upcoding is a fraudulent practice where professional healthcare providers seek more reimbursements from the government and regulatory bodies using a fraudulent CPT code than they are entitled to. For instance, if a physician checks a patient for a regular check-up that probably costs $60 but when

