Which term refers to the deliberate manipulation of CPT codes for increased payment?

The term that refers to the deliberate manipulation of CPT codes for increased payment is known as upcoding. Upcoding occurs when a medical provider illegally assigns a more expensive code to a service than what was actually provided. This practice is intended to increase reimbursement from insurance companies or government payers, leading to higher payments than warranted for the services rendered.

Understanding the implications of upcoding is essential for medical assistants and healthcare professionals as it can lead to serious legal consequences, including fraud investigations, penalties, and loss of medical licenses. It highlights the importance of accurate and ethical coding practices to maintain integrity within the healthcare system.

In contrast, other options like underbilling involves charging less than what should be charged, which is not a manipulation for higher payment but rather a loss of revenue. Overbilling, similarly, typically connotes charging for services that were not rendered or charging for more services than what was provided but does not specifically focus on manipulating the CPT codes themselves. Unbundling refers to the practice of separating out services that should be billed together, which can also be unethical but does not directly relate to manipulating codes for higher reimbursement in the same way that upcoding does.