Which of the following practices can negatively impact reimbursement rates?

Under-coding refers to the practice of coding a patient's diagnosis or procedure at a lower level than warranted by the documentation and clinical service provided. This practice can result in decreased reimbursement rates because the healthcare provider may be reimbursed for less than what the service is worth, based on the scope of care rendered to the patient. When coding is not reflective of the complexity or resources required for the patient's care, it leads to lost revenue opportunities for the healthcare organization.

In contrast, accurate coding ensures that the provider receives proper reimbursement by clearly capturing the truth of the patient's medical conditions and the services rendered. Regular audits serve to verify the accuracy and appropriateness of coding and billing practices, helping to identify areas for improvement and ensuring compliance with guidelines. Upcoding, while also problematic from an ethical and legal standpoint, would typically result in higher reimbursement, though it carries significant risks of audits and penalties. Therefore, under-coding is specifically detrimental to revenue outcomes.