Which of the following is not a potential reason for downcoding?

A. The coding system used by the insurer does not match that used by the provider.
B. The provider uses a HCPCS code the insurer does not recognize.
C. A workers' compensation carrier converts a CPT code to the lowest-paying code in the system.
D. The payer discovers that documentation does not back up the level of code used.
E. The insurance carrier does not cover the services included on the claim.


Answer: E

Health Professions

You might also like to view...

Which of the following should be included on a résumé?

a. Age b. Photograph c. Salary information d. None of the above

Health Professions

The endoplasmic reticulum has what function(s)?

A) Neutralization of drugs and toxins B) Synthesis of proteins, carbohydrates, and lipids C) Storage and transport of molecules or materials D) All of the above

Health Professions

A Class 1A liquid has a flashpoint of

a. less than 100° F. b. less than 73° F. c. more than 100° F. d. more than 200° F.

Health Professions

Where are the stretch receptors known as volume receptors located?

a. atria of the heart c. kidneys b. bladder d. carotid arteries

Health Professions