Ethics & Law · single question

Billing an FMX as individual radiographs to increase reimbursement is an example of:

  1. Upcoding
  2. Downcoding
  3. Unbundling
  4. Overbilling
Show answer and explanation

Correct answer: C. Unbundling

Unbundling is the fraudulent practice of separating a bundled procedure (18-film FMX) into individual component parts to bill each separately and collect more reimbursement. Upcoding bills a higher-complexity code than performed; downcoding deliberately bills at a lower code.

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