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Vt. Stat. Ann. tit. 18, § 9418a. Processing claims, downcoding, and adherence to coding rules: Claims Processing and Contracting Standards – Vermont
Status: EnactedYear Enacted: 2007
Year Amended: 2011
File: Download
No health plan, contracting entity, covered entity, or payer shall automatically reassign or reduce the code level of evaluation and management codes billed for covered services (downcoding), except that a health plan, contracting entity, covered entity, or payer may reassign a new patient visit code to an established patient visit code based solely on CPT codes, CPT guidelines, and CPT conventions.
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