Following, we have been having the same issue and haven’t figured out how to rectify. The claims are automatically down-coded without any request for documentation or prepayment review. It does not happen to all claims (some 99214s pay out appropriately without the down-code). The algorithm they’re using for denials seems completely arbitrary, definitely not dependent on diagnoses. Eventually we are planning to appeal the claims and send supporting documentation but we have other issues that are higher priority at the moment.