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Exam CFE - Financial Transactions and Fraud Schemes All Questions

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Exam CFE - Financial Transactions and Fraud Schemes topic 1 question 58 discussion

Actual exam question from ACFE's CFE - Financial Transactions and Fraud Schemes
Question #: 58
Topic #: 1
[All CFE - Financial Transactions and Fraud Schemes Questions]

A particular back surgery contains two basic components (an incision and muscle repair), but it is supposed to be billed using a single procedure code. Heather performs this back surgery on a patient and submits a claim using three codes: one for the full procedure, one for the incision, and one for muscle repair. Which scheme BEST describes Heather’s actions?

  • A. Unnecessary services
  • B. Upcoding
  • C. Over-utilization
  • D. Unbundling
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Suggested Answer: B 🗳️
by 5a97e10 at Nov. 30, 2024, 12:47 a.m.

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5a97e10
4 days, 7 hours ago
Selected Answer: D
D is the correct answer
upvoted 1 times
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