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A pediatric practice in Chicago bills a level 4 sick visit for a child with three separate complaints and gets paid for a level 3. No records were requested first. A family medicine group in Michigan learns that every E/M…
Cigna, Aetna, Anthem, Humana, Molina, UnitedHealth, and regional Blue Cross Blue Shield plans are all automatically downcoding E/M claims in 2026. Maryland has fined Cigna, Indiana has passed a law, and a physician coalition says the practice repeats a scheme a 2004 court settlement was meant to end.
