Section V - Quiz

Any lie or false statement to another person

Any deliberate conduct that is inconsistent with sound fiscal, business, or medical practices, and results in an unnecessary financial cost to a federal health care program

An intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person.

Any plan to unlawfully take or steal money from another person or institution

True

False

Billing for services not rendered

Down-coding

Billing for medically unnecessary services

Upcoding

Using the CPT-4 procedure code with the highest reimbursement rate to bill a medical service

Using multiple CPT-4 procedure codes to bill the separate components of a single complex medical service

Using a single CPT-4 procedure code to bill numerous services that are required to be performed and separately billed using different CPT-4 procedure codes

Using multiple CPT-4 procedure codes to separately bill components of a medical service that are performed together and are required to be billed under the single CPT-4 procedure code assigned to the service

Free services and supplies

Experimental services and supplies

Services and supplies needed to treat an existing illness or injury

Unnecessary services and supplies