Audit fears trigger down-coding. Here's what to do

Article Overview

This article examines how concern about Medicare audits can lead physicians and coders to submit lower-level evaluation and management claims than they believe are justified. It discusses survey findings from MedPAC, the impact of fraud-and-abuse fears on billing behavior, and a general approach for reviewing code-distribution patterns against specialty norms. The piece is relevant to physicians, coders, billing staff, auditors, and compliance professionals who want to understand how audit anxiety can affect claim patterns and revenue.