What best describes upcoding in medical billing?

Upcoding in medical billing refers specifically to the practice of billing for services that do not correspond accurately to the actual services provided, often at a higher level of complexity or cost. This results in a misrepresentation of the services rendered which can lead to inflated reimbursement from insurance companies. Such practices not only violate ethical billing guidelines but can also constitute fraud, leading to significant legal consequences for healthcare providers.

In contrast, other options describe different fraudulent or unethical billing practices. Billing for services not rendered pertains to false claims where providers charge for procedures that were never performed, while representing new patients as established ones typically focuses on manipulating patient classifications to receive higher payments for follow-up visits. Filing claims for experimental treatments involves charging for procedures that may not yet be covered or approved, rather than misrepresenting the services rendered. Each of these practices falls under different categories of fraud within healthcare billing, but upcoding specifically targets the intentional misstatement of service levels and associated costs.