Wiki DOWNCODING

[ARON-A]

Hi All

Somebody help me on the topic down-coding

I have found a patient is new but it has been coded with established CPT 99214 hence i have changed CPT 99214 to 99203 but the dollar values has been similar for both the cpt should i consider this as an Down coding ?

 

[mitchellde]

It is not downcoding if you are following the guidelines and the documentation supports the 99203. IF it supports a 99204 then that is what you should code. you cannot determine the correct visit level without the visit note.

 

[Pathos]

Here is a good article on Down-coding by one of AAPC's staff members:

Upcoding vs. Downcoding: Know the Difference
by G. John Verhovshek, MA, CPC

 

[ARON-A]

It is not downcoding if you are following the guidelines and the documentation supports the 99203. IF it supports a 99204 then that is what you should code. you cannot determine the correct visit level without the visit note.

yes i have reviewed the full visit note thoroughly it is supporting for 99203 only , Thank you for your information

 

[ARON-A]

Here is a good article on Down-coding by one of AAPC's staff members:

Upcoding vs. Downcoding: Know the Difference
by G. John Verhovshek, MA, CPC

Thank you so much for referring this article it is very useful..