What are you doing for Aetna computer downcoding?

[dgdg]

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So we are seeing Aetna down coding some of our 99214's without a chart review. They just appear on our remittance reports.
Have you all found a system or process to prevent them?

 

[chessknt]

We just did an audit and found this didn't happen to any of our charges so it may be regional or specialty-specific. If you have a physician advocacy group that you have any activity in bring this up as this will become more prevalent the longer it is allowed to run unchecked.

The general advice is to put as many diagnoses in the a/p regardless of whether or not they are relevant