Which practice refers to misrepresenting a diagnosis to justify a higher payment?

Upcoding refers to the practice of misrepresenting a patient's diagnosis or the level of service provided to receive a higher reimbursement from insurers or government health programs. This tactic involves coding a patient's condition or treatment with more severe or complex codes than what was actually warranted based on the medical documentation. By doing this, healthcare providers can increase their payments unjustly. This not only undermines the integrity of medical billing but can also lead to audits, penalties, and a loss of credibility within the healthcare industry.

In the context of the other options, co-payment fraud involves unlawful actions related to co-payments, usually impacting the patient side of the transaction rather than the coding of diagnoses. Overbilling generally refers to charging for more services or supplies than were actually provided, which is more about billing practices rather than the specific act of misrepresenting a diagnosis. A kickback scheme involves receiving or giving financial incentives for referring patients or services, which is unrelated to the coding of diagnoses and payments.