# Internal Audit - upcoding etc.



## maine4me (Apr 10, 2012)

When a service has been upcoded and was applied to the patient's deductible, how do you handle this?  Do you just leave everything as is?  I guess they patient would have to pay the deductible either way, but it does not seem right to keep the money.  I would appreciate any one's advise.


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## mdoyle53 (Apr 10, 2012)

It would depend on the seriousness of the upcode.  If it was off by one level, I would leave it alone.  If it was off by more than that, I would resubmit to the insurance carrier which would bring the allowed amount down and hence the patient overpaid and would be necessary for a refund to the patient.


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