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Upcoding

Medical billing & coding glossary · all terms

Definition. An illegal practice of assigning an ICD-10 diagnosis code that does not agree with the patient records for the purpose of increasing the reimbursement from the insurance payor.

You'll come across Upcoding while working the revenue cycle — from eligibility and claim submission to payment posting and denials. See the related terms below, or browse the full glossary and the Knowledge Hub.

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