Undercoding Is Just as Costly as Fraud. And It's Far More Common.
Routinely billing lower-level E/M codes 'to be safe' isn't compliance — it's lost revenue. Learn how to code accurately without fear of upcoding accusations.
Providers are rightfully cautious about upcoding. But the overcorrection — routinely billing lower-level E/M codes to "be safe" — is costing practices real money.
If a level 4 visit (99214) is documented and supported, billing it as a 99213 doesn't protect you. It pays you less for the same work.
The goal isn't to code higher. It's to code accurately.
What does your E/M distribution look like? If 80% of your visits are 99213 regardless of complexity, that's worth a second look.
Accurate coding is not aggressive coding. It's doing the job correctly.
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