Key takeaways from this episode

• Payers are downcoding level 4 and level 5 E/M visits to level 3, often hidden behind an adjustment code that auto-posts. Some payers have official policies and others unofficial ones; the downcodes are a broad "shotgun" approach with no clear pattern, and revenue cycle staff must watch for them because 50% or more of these claims are never resubmitted or appealed.
• Half of the appeals get upheld at level 3 because the documentation did not support the 4 or 5, and the AUA was shown such records when it asked payers to stop. The work may have been done, but the note has to show it; physicians who drop brief, unsupported notes and charge 5s because of their expertise are feeding the payers' justification.
• Submitting claims with documentation attached can get a practice removed from a payer's chart-review program. PRS has done this for several billing clients; payers back off when it costs them money to process and lose, and one payer said it will release practices that hit a 70% or better rate, but the practice has to make that argument.
• AI coding and ambient tools do not remove the need to know the rules. They miss orders that read as suggestions, data that was reviewed, and wording problems: a BPH patient up two to three times a night who is offered another drug or a minimally invasive therapy but "says he is doing fine" gets coded a 3 instead of a 4 unless the note states the problem is chronic and worsening or not at treatment goal.
• Risk is only one of the three MDM elements, and data counts by source, not by test. Recommending medical therapy, MIST or TURP over observation supports level 4 or 5 risk, but a urinalysis, CBC and basic metabolic panel all from the same hospital count as one data point, so say explicitly what was reviewed and where it came from.
• RAC auditors and payers do fish, and sacral neuromodulation is a standing example. Repeated RAC rounds under the NCD denied claims because the practice could not produce the bladder diary showing 50% improvement between the test phase and the final implant.
• To bill 76872 with a prostate biopsy, the note must document a diagnostic transrectal ultrasound that describes the prostate anatomy, not just "saw a lesion and biopsied it." Under the new 2026 biopsy codes, day-of-procedure diagnostic ultrasound will no longer be paid separately, but targeted lesion and sextant biopsies and the each-additional-lesion code will require their own specific verbiage.
• Every test or treatment needs an explicit statement of medical necessity, and denial posting needs to be detailed enough to audit. If denials all post as contractual adjustments, finding downcodes requires a deep dive into percentages, fee schedule, billing patterns and RVUs; PRS also offers a Documentation for Reimbursement video series on the level 3, 4 and 5 differences.

Transcript

Lightly edited for readability; timestamps mark where each speaker turn begins in the recording. UCR 265, recorded October 2025, with Scott Painter, Mark Painter and Dr. Ray Painter of PRS Network, and guest Dr. John Lin.

Introduction and the Halloween episode titles

[00:00] Scott Painter: On today's episode: the curse of insufficient documentation. Stay tuned. Welcome to episode 265 of the Urology Coding and Reimbursement Podcast. I'm your host, Scott Painter, with my co-host Mark Painter and Dr. Ray Painter, and we want to welcome back special guest Dr. John Lin, a frequent visitor. Thank you, John, for coming on and working with us today.

Dr. John Lin: It is always a pleasure, and I can't wait to provide more value to our audience.

Scott: All right. John is the founder of the Thriving Urology Practice Facebook group. How many members do you have now, John?

John: I think over 3,200 US-based urology practice folks.

Scott: And how does somebody join if they haven't heard of it? I'm sure most of our listeners are active members, but if they're not, what do you suggest they do?

[01:00] John: Interestingly, if they're not, they're one of the few people in this world who doesn't have Facebook. But if they're not, they usually tell their administrators or their coders and billers or their physicians who have Facebook to join. All you have to do is look up Thriving Urology Practice on Facebook, however you access it, on your desktop or your mobile, answer a very few questions, hit submit, and you're done.

[02:00] Scott: All right. As we're recording, this is our Halloween episode, if you couldn't tell from the title, and we had a lot of titles to choose from. I just want to read you a few of them, because I think they're pretty clever, pretty awesome. Thank you, John, for giving us some good topics to choose from. We've got "The Ghosts of Prior Authorization"; that would have been a great episode. "The Graveyard of Missed Updates." I like that one. "The Scariest Gaps: When APPs and Staff Aren't Trained." "The Ghosts of Incorrect Coding." "The Cystoscopy Catastrophe"; that's one I'd really like to hear. And "Phantom Documentation: The Operative Note Trap." Those were all really good suggestions for today's episode, and we appreciate you coming up with all those, John. We'll have to save those for the future, but today we want to talk about the curse of insufficient documentation. John, why this one? This one's at the top of your list. Why this topic, and introduce what we're going to be talking about today.

[03:00] John: Truly, any time you talk about any one of these topics, you can unravel the thread of revenue cycle management. You can talk about pretty much every other topic you introduced earlier. So the curse of insufficient documentation, I think, will cover pretty much all of what we will end up talking about today as far as revenue cycle management, coding and billing. I want to talk about cases where poor documentation led to audits by insurers and payers, possible clawbacks, frustrated practice owners thinking, "I did all this work; how come we're not seeing the return on the work that was done?" And then the payers coming back, looking at your documents, and possibly now computers looking at your documentation, saying that you failed to support the medical necessity of whatever you did, and you don't deserve to be paid. That, I think, will cover pretty much anything and everything you mentioned earlier.

Payer downcoding of level 4 and level 5 E/M visits

Scott: All right. Well, let's kick this off. Mark, what do you have to share with us about insufficient documentation?

[04:00] Mark Painter: I'll start with the first one that we're all dealing with at the moment, and that's the downcoding from many of the payers. We've got official policies from some of them, and unofficial policies from many of the other big payers, where you submit a level 4 or a level 5 E/M, whether it's new or established, and they pay you on a 3, typically with an adjustment code that hides it within your practice management system if your revenue cycle team isn't really looking for that automatic posting. Those things can skate by your original posting team if they're not paying attention, because a lot of that's done by the computer. And then you've got five or six different things in the bucket you're trying to deal with that are more easily identified, and sure enough, these things just pile up.

But the reason the various private payers dropped into this entire program was that they would look at charts, and they weren't sufficient to support a level 4 or a level 5. Now, the work may have been done, but the documentation really wasn't there, and that's one of the things we see. And certainly with the assistance of computer-assisted coding, AI, all these automated tools, it makes it easier for the payer to run a bunch of charts through a system and decide whether or not it's coded correctly.

When we look at some of the statistics coming back, we always harp on the first one: 50% or more of the claims that are denied this way don't get resubmitted or appealed. So that's a win for the payer right off the bat. Now, that's not insufficient documentation; that's just burying your staff in a lot of work that doesn't get done, or not having everybody trained the right way. But the other part is that of those that are appealed, 50% tend to get upheld at level 3 because the documentation didn't support the higher level, the 4 or 5. As a payer, it's really hard to ignore those numbers. That's why they're running this, and that's probably the defense they would use if anybody tried to take them to court. But the amount of work it's causing everyone is ridiculous.

Now, I can tell you that we've had a few of the revenue cycle groups we do billing for that, by submitting all of their claims with documentation, we've been able to get taken off of that chart review. It did take a little bit of extra work to do it, but based on the documentation, you can reverse that trend from the payers. They will back off if you are the one who's winning, because it costs them money to process and lose. It makes them money to process and win with denials, but it costs them money to process and then have to pay.

Scott: Watch out for that. And how many have you appealed? You had mentioned when we were preparing for this that it was in the tens of thousands through your revenue cycle group.

[08:00] Mark: It is. As far as the groups we've got, some of the larger groups, this adds up very quickly as you walk through each one. If you do 2,000 for a single payer, that adds up pretty quickly when you run it across multiple payers. They are downcoding fairly frequently. They're not doing everyone, and the worst part is there's not a real true pattern. They're just randomly looking at 4s and 5s, not looking at the diagnosis codes as much. I imagine they'll get a little more sophisticated as they go down the road, but right now they're in the study phase. So those things are coming through all over the board, and it adds up very quickly. One practice, two practices, three practices, and when you've got 40 different practices out there, it's easy to see how fast it adds up into the tens of thousands.

Why payers are downcoding: the evidence, the rules and the economics

[09:00] John: So what I'm hearing you say, Mark, is that some of the denials, the downcoding by the payers, is legitimate, meaning the doctors or the APPs are not documenting sufficiently. Even though they did level 4 or level 5 work, they're not doing a good enough job with their documentation, which leads to appropriate downcoding. And now the payers have ammunition to say, "I found a few of these that you didn't do correctly, so we're just going to do widespread, indiscriminate downcoding of your level 4s and level 5s." Then those in the practice who are doing things correctly, documenting correctly, actually doing the work of a 4 and a 5, are being punished on the back end.

Say the practice is doing a good job with their documentation, actually doing the level 4 work and documenting correctly. With these wide denials and significant numbers of downcodes, the practices are being overwhelmed with the number of denials they now have to deal with, and they don't have the capacity, the bandwidth, to deal with all of them. This reminds me of something on the internet called a distributed denial of service attack, where nefarious actors overwhelm a website's servers so the website cannot do any work. In a similar fashion, I think one of the tactics by payers is to overwhelm the practices with these downcodes. The coders and billers are thinking, "I don't have enough bandwidth just to deal with the everyday work that's coming in. How do I have the bandwidth to work on these claim denials and downcodes?"

[11:00] Mark: That's true. And I'll give a couple of credits to the AUA for some of this information. The AUA did make a run at a couple of the payers to say, "Stop doing this." They have some decent relationships with some of the high-level payers, and the AUA was told, "Let me show you some records that came in as 4s and 5s," and it was pretty obvious that it did not support a 4 or 5. It was a 3. So we definitely have that evidence that the payers use as the first line of defense for why they're doing what they're doing.

Then I would add the second piece, and John, you and I have dealt with this: the payer's rules are not always 100% accurate. We had that battle with United about vasectomy coding and what the appropriate level should be. So there's some interpretation that does take a next-level argument, but a lot of what they're doing this time through is fairly straightforward downcoding and reads of the notes.

And then the last piece: unfortunately, there are a number of urologists, and physicians across the board, I shouldn't say just urologists, who just don't pay attention to the rules or their documentation. They see difficult patients, they drop things in very briefly, not very well documented, not very well supported, and they charge 5s because they think they are owed a 5 because of their expertise. All of those things taken together have really led to this system that is slowing things down. And the last piece I'll add on top of this is that right now most of the payers' stocks are in the tank. They're raising rates, they're going to lose a number of people from paying premiums, and that leads to insurance companies needing to figure out how to bump their margins. One of the easiest first steps is to increase administrative work on physicians: step up prior authorization, step up denials for various reasons. This downcoding is just another tool in the chest they're using at this point in time, with some justification.

[14:00] John: There are so many different topics there, Mark. For those of us who are not looking at the macroeconomic factors, just look at the US economy and the pressures from the political climate on the health insurance companies, then you miss out on why the health insurers are doing what they're doing. UnitedHealthcare stock recently tanked, and it's multifactorial. UnitedHealth Group's stock tanked, and the Inflation Reduction Act had an impact. I think over a million people now no longer have their Medicare replacement plans, also known as Medicare Advantage plans; I call them Disadvantage plans. They lost coverage because the insurance companies are saying it's not worthwhile for us to provide that service. And you need to remember, the insurance companies are beholden to one group of people, and that's their stockholders. They're profit-driven, and how are they going to ensure that continued profit to their stockholders? By putting up hurdles, what Mark is talking about: downcoding, denying claims, prior authorizations and things like that.

Not knowing the rules: I get it. Every time we do one of these presentations at the Urology Advanced Coding and Reimbursement Seminar, I'm so empathetic, because yes, we all went through, for the docs, five or six years of urology residency after four years of medical school and four years of college, and now you want me to learn about coding and billing and these stupid rules. I totally get it. But unfortunately, if you are going to participate in this third-party payer scheme, it is imperative that you understand these rules and try to at least have a basic understanding of evaluation and management. This is something you're going to do every single day, so spend a little bit of time learning it. It's not difficult. If you can get through residency, you can get through this evaluation and management thing. Think of it this way. When the evaluation and management rules changed in 2021, I thought to myself, I'm going to use this for the rest of my working career, so I'm going to learn it. I'm going to master it so I can cruise through my daily clinic, documentation, coding and billing and not have these stupid downcodes.

Can AI make the documentation problem go away?

[16:00] Scott: What about AI? Can't I wait it out for AI to come in and make this magic happen, or do I still need to know the rules? That's what a lot of people are asking themselves. What's the thought on that, and why?

[17:00] Mark: That's an interesting and good question to ask. We've interacted with AI now in several different ways, so I'll start with one. As we've watched some of the folks implement AI, there are a number of things we've seen through chart reviews that get missed, not necessarily because the AI doesn't understand the rules, but more that the AI doesn't see everything that goes on. A lot of people jumped in with ambient listening AI with coding tools, and remarkably, they come out pretty close to what is actually said within the room. But what we missed was all the orders, the details of what data was reviewed. Maybe some of the orders came through as suggestions and not orders. So there are little things that get missed that actually make a difference to your final code. That's one thing.

The other thing is the way things are worded, and I'll give an example. If we are reading through a chart and we see that a patient has BPH and they're getting up two to three times a night, and the physician is saying we could start a different drug or we could talk about maybe a minimally invasive therapy, but the conclusion at the HPI was the patient is doing fine, the patient says they're doing fine. So in one part of the chart it's "doing fine"; in another part they're recommending other services. We would look at that as a chronic problem that is not at treatment goal. The BPH isn't where we want it to be; we're offering more therapies, more pathways for the patient to have a better life and treat their BPH; the patient is refusing it and says they're doing fine. The AI goes through that and ends up with a 3 instead of a 4, because of the way it's worded, not necessarily because it doesn't understand what was said. That's another piece of this. So make sure you really understand the rules as you're going through the process of working with AI, and understand where there are going to be misses, because AI is a tool. It's not going to think for you. It's going to recognize patterns and project. Somewhere down the road we may get further and it may be able to infer those things, but during the transition phase you're going to need to make sure you understand how to protect yourself, to still get paid for all that you do, and leverage the AI as it is.

The other piece I'll say is there's a lot of AI coding out in the marketplace, and we're starting to look with some companies at the general rules they're feeding into the AI. If you think of them at a high level, if you just push the wall chart into an AI, "here are your rules," that doesn't understand the nuances of urology. So you've got to actually work with the AI, give it the feedback, and work with a company that is willing to listen to you as a practitioner, you as an office practice, to design AI that actually picks up the nuances of your practice and the practice of urology in general. We need to be in AI and helping shape AI, instead of what we did with EHRs, which was to let the folks in the tech world create it, drop it in our lap, and then move forward with maybe some adjustments. It's better to get in on the ground floor. That's why we're starting to jump in and see what we can do to help design, develop, test, retrain, hone and make these systems better. John, anything to add?

Documenting for the next clinician, the lawyer, the auditor and the AI

[21:00] John: Yes. This is the usual disconnect that Ray has mentioned many times in the past between the documentation requirements to take care of the patient clinically and the way I document. Not only do I need to do it so well that whoever takes over the care of that patient knows exactly what I'm thinking today and what I plan to do, but it also has to cover me medico-legally if there's some action. And now you also have to document for coding and billing. That's the disconnect between knowing, "This is what I did for the patient," and, "This is what the AI needs to hear to appropriately code at the level that is correct for the service provided today."

For instance, Mark, in this BPH scenario, you talked about medical therapy, maybe minimally invasive surgical treatment, maybe something more invasive like TURP or simple prostatectomy. You can talk about all of that, and it actually qualifies for a level 3 visit. However, in my documentation I will say I recommend a particular treatment, and not active surveillance or observation. That brings up, typically, medical therapy, or MIST, or TURP, and those are level 4, if not level 5, risk recommendations. But the urologist needs to understand there are three elements in evaluation and management, and now we're talking about just one element, risk. Within risk you now have a 4 or 5. What about the other elements? Being able to understand that, and speak in a way, if you're using ambient AI, that the AI will easily pick up and understand, that is the key.

When it comes to data, when it comes to looking at the documentation, you would have to explicitly say, "Mr. Jones, I looked at your urinalysis that came from the local hospital, I looked at your CBC, I looked at your basic metabolic panel, and here are the results." That's three data points. However, the AI needs to understand that these possibly all came from a single source, and then that will be one data point. That little nuance is going to be very difficult for the AI to discern unless there's other input. So again, the physician needs to understand the coding and billing to start, and then I think the AI will catch up. Medicine is pretty darn nuanced. You can try to force structure into coding and billing, but it is also up to the person seeing the patient to provide the context in which the data will fit into the coding and billing structure.

Scott: Ray, your thoughts?

Saying the right words, payer fishing and RAC audits

[24:00] Dr. Ray Painter: Well, I'd like to reinforce a couple of things that Mark and John have already said. I'll start by saying these rules we go by are not difficult; they're just detailed, and you have to understand the rules in order to do what we've all talked about for many years, which is document for reimbursement. That's what Mark and John have just told you. The example of the patient with chronic BPH that you're still treating, maybe going to put on another drug: you have to say that it is a chronic problem, worsening. You're doing that for the auditor the payer has hired, who really doesn't understand coding, and you're also doing it for the AI as well. And you have to fit that into every rule you're dealing with. You could have documentation that is 100% complete and accurate for all the clinical material, but if you don't say the right words, an auditor or an AI or a computer is not going to give you credit for what you've done.

And the second point, Mark: are these payers fishing? In other words, will they go into a big practice and maybe downcode one of the docs to see whether the practice is watching or not, and if they don't appeal, then go in and downcode the whole group? Or are they just putting one group at a time on downcode?

[26:00] Mark: I'm going to say yes and no. The downcodes are pretty broadly spread; it's a much larger shotgun approach they're using, so that one's a little bit different. But there's no question that RAC auditors and payers do fish. They go after different practices at different levels with different targets. They look at one thing and then they go from there, and that's what we're seeing with the requests for RAC audits and then the re-requests. Over time we've seen a number of different RAC audits surrounding sacral neuromodulation. That was specific to an NCD. Most of the denials came back because the practice couldn't produce a bladder diary for the patient between the test phase and the final implantation phase, and the 50% improvement wasn't there. They tried that with a few different groups, they found it, and then they went at a broader swath. Then they turned around and went back to look at it again to see if anybody had actually learned, and there was a new round. So there's always fishing, but there are also tactics they use that are more broadly just scattershot. And yes, they'll identify specific practices. This is one of the things they said: "We will let practices off if they're at a 70% or better rate," or whatever percentage they said, but it's up to the practice to actually make the argument to take that away.

Ray: The other thing we've seen through the ages is that doctors are very trusting. When they have staff they trust, they think everything is going well: "I know my staff is doing their job." So if I'm in practice and I wanted to double-check, just to be sure we're checking whether we're being downcoded or being denied things we shouldn't, what can I do? Do you have the capacity in your group to check on an office to see how things are going?

[28:00] Mark: We do, but I will tell you as well, there are certain things that can be hidden based on the way the system is done and how you're set up. We can look at percentages, and reports are a starting point we look toward. Hopefully the system is capable of posting denials by reason. Those we can search through and identify easily. If everything goes under contractual adjustment, or the staff is lazy, or you just don't have a system that can post everything to the detail you get from an EOB, that dive is much more difficult. It really takes some understanding of where your percentages are, where your fee schedule is, your billing patterns, your RVUs. So that's a much deeper dive and a harder look. There's not a one-size-fits-all way to do that sleuth work. It can be done, and we definitely can dive through and see that, but the amount of work it takes is really dependent on the infrastructure you have supporting you.

John: Similarly for coding and billing: garbage in, garbage out. If you don't put enough information into your practice management software, you're not going to be able to get meaningful information out. Likewise, when it comes to clinical documentation, if you don't put in relevant information for coding and billing, and also for clinical relevance and medico-legal defense, then you're not going to get a good data set for those purposes.

Surgical templates, prostate biopsy ultrasound and medical necessity

[30:00] Mark: True. A lot of what we've talked about today has pivoted around E/M, necessarily, because that's one of the high-volume things we deal with. But the other thing we're seeing is some of the misses on the surgical side. Most people have developed templates to deal with their common procedures, which is a great idea, with short phrases and those types of things. But not everybody is fully utilizing the templates to a degree that gives us the support we need to actually go through and do appeals or look into any type of denial. One thing I was reminded of recently, as we've been talking about prostate biopsy coding and the new changes coming up, is 76872. If you use it to get paid a little bit better, because some payers don't pay it, that requires that you actually dictate or include in your documentation, one way or another, a diagnostic transrectal ultrasound that really talks about the anatomy and what's going on with the prostate. Not just "I saw a lesion and I biopsied it," or "I did a sextant biopsy."

And then as we go into next year, with the detail that's required relative to the new codes and whether or not you're going to be able to bill the each-additional-lesion code, we're once again going to need to adjust how we document. We're not going to get paid anymore for diagnostic ultrasounds on the day of a procedure, but we are going to be able to get paid if we're doing specific lesion biopsies and sextant biopsies and those types of things. That verbiage now needs to start to shift to give us that documentation.

The last piece I'm going to add, because I know we're running out of time, is the medical necessity piece. That's the other one that misses a lot. Why are you doing what you're doing? You may understand it, but it's not always something that is easily inferred from your documentation. So you want to make sure you're dotting your i's and crossing your t's so that you have the medical necessity for any test or treatment you give.

Sponsor, the seminar and final thoughts

[33:00] Scott: Okay. Well, let's wrap this up here and get some final thoughts. First, I want to say thank you to ModMed for supporting this episode. If you're in the market for an EHR or a practice management system, you can go to modmed.com/prsnetwork for specials for our listening audience. And we want to thank you all for listening. I will mention that this discussion, and learning the rules, is a lot of what we cover in our Urology Advanced Coding and Reimbursement Seminar. These are topics we go over in detail, and we encourage you to join us in December in Las Vegas, December 5th and 6th, or at the end of January, January 30th and 31st, in New Orleans. You can go to prsnetwork.com, and right there on the homepage there's a seminar registration button you can click to get more information and check out everything we're going to be talking about in this year's seminar. Okay, let's get some final thoughts. We'll go around the horn, starting with John, then Mark, and we'll wind up with Ray. Final thoughts, John?

[34:00] John: Listen, I get it. This is a lot to ask for some of you. You're taking care of patients, you're super busy, you're just trying to get through the grind of the day, and now you are being burdened with this coding and billing mumbo jumbo. But I'll just say there are reasons why some urologists are very happy walking into the practice with a very light step, very joyful, looking forward to the day, and there are those who struggle, thinking they are pedaling on a treadmill and not going anywhere. For a lot of those folks, the difference is understanding the rules of the game. And it is a game you're playing. If you understand these rules, you can apply them to your advantage. This is similar to the tax code: if you understand the tax code, you can leverage it to your advantage. If you understand the coding and billing rules, you can leverage them to your advantage. It doesn't have to be a grind. You can learn this stuff; it is relatively straightforward. Once you get the big picture, then you can start thinking, "Here are some of the tweaks I can do in my practice." The big change for seven states will be the WISeR program in 2026 for Medicare. The big change for all urology practices in 2026 will be the huge change in the prostate biopsy codes. Understanding the nuances, understanding the big picture, will help you in the long run. Think of it this way: it's an investment you make now that will continue to pay off every single day.

[36:00] Scott: Well said, John. I do like you bringing up the concept that if you understand the billing and coding, it makes your whole life in practice better. That's what we've heard a lot throughout the years: once you understand it, it changes your whole practice. It's something we believe in strongly, and we want to help you. That's why we do all these things we're doing, trying to get you the information you need. All right, Mark, final thoughts?

[37:00] Mark: A couple of things I'll add onto that, and John said it well. On the investment side, it is one of those areas that takes some time, but you've seen it in all that you do throughout your life: understanding how to use a tool, or understanding the general instructions for how to interact with a system, is key to being able to function within the marketplace we have in the US. And I'm excited about AI. I think it's going to be something we're all going to enjoy at some point, but there is a transition period coming through, and we need to be participants in the development of this. That's going to take knowledge, again, of what needs to be in the system, how it interacts with urology, what's the most important part of the clinic visit from a clinical standpoint, but also what's important from a coding and billing standpoint. All of those things need to be addressed, understood and monitored in order for that raw tool to be trained to function as a real add-on to your practice and make your life easier.

So again, exciting times, scary times as well, with everything going on within the next couple of years. We've got a lot of changes. John mentioned a few of them: WISeR, the prostate code changes, AI coming in, and we've got a lot of folks who are probably going to be dropping their insurance coverage or no longer covered. All of those are challenges we have to meet. At the same time, I know you're all dealing with staffing issues; it's a wild west issue we're all dealing with. Trying to take a few of those difficulties and make them a little bit easier day to day is going to make your life a lot better. So I'd encourage you to make the time, make the investment, as John said, in understanding documentation.

Scott: Ray, final thoughts?

[39:00] Ray: Knowledge is power. We all know that. Just think of the surgeries you've gone into that you've done many, many times before, in your comfort zone, versus the one that's brand new, that you've never done before or maybe assisted on. On the E/M documentation, we have a series of videos, Documentation for Reimbursement, which will give you the detailed differences you need to document between a level 3, a level 4 and a level 5. These are about 20 minutes each and well worth your time. And one thing I'd like to mention about AI: if you cut to the chase, AI is another computer. It's still zeros and ones, and it's garbage in, garbage out. So Mark, I'm glad you and your team are working with AI to be sure we get a system that works correctly and accurately.

Scott: Yes. All right, that's all we have for today's episode. Thank you all for listening. Take us out, John.

John: Happy coding, everyone.

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