Downcoding definition
Downcoding means the adjustment of a claim submitted to a dental benefit plan to a less complex or lower cost procedure code;
Downcoding shall have the meaning assigned to that term in § 7.19 of this Agreement.
Downcoding means the adjustment of a health benefits claim
Examples of Downcoding in a sentence
No Automatic Downcoding of Evaluation and Management Claims 42 7.20.
More Definitions of Downcoding
Downcoding means the adjustment of a claim submitted to a
Downcoding means the adjustment of a health benefits claim submitted to a payer to a less complex or lower cost service in order to reimburse a provider in an amount less than is required pursuant to the provider contract. “Downcoding” includes, but is not limited to, the use of remark codes.