Medical Coding Practice Test 2025 – 400 Free Practice Questions to Pass the Exam

The potential consequence of coding fraud for healthcare providers primarily includes legal repercussions and fines. Engaging in coding fraud—such as deliberately misrepresenting services provided, inflating billing, or falsifying patient records—can lead to serious legal challenges. Authorities such as the Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) actively monitor and investigate instances of fraud in the healthcare system. If a provider is found guilty of fraudulent practices, they could face substantial fines, loss of licensure, or even criminal charges.

In contrast, the other options suggest outcomes that are generally positive and unlikely to result from coding fraud. Increased patient satisfaction, improved reputations, and higher approval rates from insurance companies are all reflective of legitimate and ethical practices within healthcare. Engaging in fraud typically damages a provider's reputation, undermines patient trust, and can result in denials from insurance companies or lowered reimbursement rates, rather than increasing approvals.