The health of many independent practices is tied to the reimbursement of their E/M codes (99202-99205, 99212-99215). The trend among payers to downcode these services has an impact on independent physician practices, though its significance may be undetected because practices do not know how to identify and track patterns in downcoded services. Practices must have a plan in place to anticipate and respond to automated payer adjustments. The talk will outline steps to improve a practice’s billing processes to avoid lost revenue due to downcoding of E/M codes and to standardize an appeal process to expedite the recapture of lost revenue. The talk offers practical advice for all members of the revenue cycle team and providers. • Trends in payer downcoding of E/M codes—the specifics of major payer policies • Track payment variances through use of EOBs to identify downcoded claims • Identify patterns in payer adjustment reason codes in Level 4 and 5 downcoding • Identify providers in your practice with a high percentage of E/M adjusted reimbursements • Recapture practice revenue through standardizing appeal processes • Expediting appeals using AMA appeal template letters • Guidance to physicians on proper documentation of E/M elements: problems addressed, data reviewed and risk. • The importance of capturing all diagnoses treated to capture MDM complexity • Where the disconnect between physician documentation and coding can lead to a gap in medical necessity required to support the claim