A payer may __________ a procedure that it determines was not medically necessary at the level reported.
A) bundle
B) concurrent code
C) upcode
D) downcode

Question

Quizplus · Accepted Answer

A payer may downcode a procedure if it determines the procedure was not medically necessary at the level reported. This means the payer will reimburse for a lower level of service than was billed.

A Payer May __________ a Procedure That It Determines Was