What best describes the action of submitting multiple codes for a single medical procedure?

Prepare for the ACFE Certified Fraud Examiner (CFE) Financial Transactions and Fraud Schemes Test with our comprehensive quiz. Engage with flashcards, multiple choice questions, hints, and explanations. Ace your exam!

The action of submitting multiple codes for a single medical procedure is best described as unbundling. This practice involves breaking down a single comprehensive procedure into several separate components, which are then billed individually. This is typically done to maximize reimbursement, as each individual code may have a different fee associated with it. Unbundling can lead to increased costs for the payer and is considered a fraudulent practice if done intentionally to misrepresent the services provided.

In contrast, the other terms do not accurately represent this fraudulent action. Decompressing more commonly refers to reducing the pressure or stress of a situation and is not relevant in the medical coding context. Procedure compounding involves combining several procedures into one, which is opposite of unbundling. Fictitious services denote services that were never actually provided, which is a different form of fraud altogether. Therefore, unbundling is the correct term that captures the essence of submitting multiple codes for what essentially amounts to a single medical procedure.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy