The American Medical Association (AMA) has also developed resources to assist practices in the fight against inappropriate downcoding. AMA guidance on payer E/M downcoding programs provides information and tools to assist practices in recognizing and fighting downcoding and help ensure payment for downcoded claims, even after the fact.
The ACR Insurance Subcommittee (ISC) engages with health insurance payers on behalf of the ACR and its members, routinely addressing concerns about reimbursement and administrative burden while ensuring continued access to critical therapies for rheumatic disease patients. For more information about the issue above or to request ISC assistance with another payer issues impacting your practice, reach out to [email protected].
