E&M downcoding is becoming a growing concern for providers, coders, and revenue cycle teams. As payer scrutiny increases, organizations need to understand what is happening, how it may affect reimbursement, and where documentation, claims review, and appeals fit into the response. This session will look at the issue from multiple angles and discuss practical considerations for providers trying to protect revenue while supporting accurate coding and compliant documentation.

Learning Objectives

  1. Explain the factors driving increased payor scrutiny of E&M claims, including recent guideline changes and evolving reimbursement patterns.
  2. Describe how E&M downcoding can affect reimbursement, documentation, and revenue cycle operations.
  3. Identify practical steps providers and revenue cycle teams can take to monitor, respond to, and prepare for E&M downcoding activity.

Thursday, April 16, 2026, 11:30 am PT / 1:30 pm CT / 2:30 pm ET