Changes in Coding Intensity Suggest How Upcoding Is Happening Across Outpatient Settings

From 2018 to 2023, the share of visits coded at higher complexity levels increased across all outpatient settings, including emergency departments (e.g., CPT 99284 increased from 32.5% to 39.6%), urgent care centers (e.g., CPT 99204 rose from 34.0% to 40.6%) and physician offices (e.g., CPT 99214 grew from 38.5% to 45.0%). All ICD-10-CM chapters saw an increase in high-acuity billing, with particularly large gains for eye and ear-related diagnoses in emergency departments, circulatory and hematologic conditions in urgent care and mental health diagnoses in primary care.

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Source: https://www.trillianthealth.com/market-research/studies/changes-in-coding-intensity-suggest-upcoding

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