Definition of downcode in English:
1Designate (a medical procedure or insurance claim) with a lower value: an insurer who systematically downcodes professional charge submissions for critical care services [no object]: we cannot turn to Medicaid to pay if Medicare downcodes
More example sentences
- Several lawsuits by providers charge Aetna and other insurers with programming their systems to ‘downcode’ claims, resulting in reduced reimbursement.
- So, some of physicians charges for critical care services are automatically downcoded and some are not.
- downcoding noun
- Example sentences
- In the same letter, they pointed out that there is no support for this practice - termed ‘downcoding ‘- in either Oxford's provider manual or New York state law.’
- Downcoding is common among family physicians.
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