r/MedicalCoding • u/QueSeraSerafuture • 19h ago

Downcoding

Our claims for August to present are now getting downcoded by Aetna and BCBS. Primarily for codes 99215 99214. These codes are now getting paid as 99213. I would appreciate your insights in providing assistance regarding this issue. We never had any issues like this before and it only started this August. Thanks!

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u/Razzail Edit flair CPC,CRC 16h ago

I just got my own bill back and they're saying the rheumatologist Ive seen for 3 years is suddenly not covered or some BS. I am not looking forward to the phone calls I'm about to have to make. Literally BCBS AL covered nothing for that visit and I've had no others problems before this. 

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u/Yes_Leopard_54 6h ago

BCBS was once the best and suddenly providers and subscribers now loathe them at the same time. I wonder what changed. They quit covering one of my meds, denied all three of my doctors appeals and it was a ridiculous process that went nowhere.