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AOA urges practices to review and appeal downcoded claims
AOA urges practices to review and appeal downcoded claims
August 19, 2026
The AOA’s updated guide to downcoding.
Key Takeaways
- The AOA receives a significant number of reports of downcoding from doctors of optometry across the country.
- Generally, a doctor must appeal at least 70% of their downcoded claims and be successful in the majority of those appeals to be removed from the program.
- That’s why practices must consistently review downcoded claims and appeal those that do not accurately reflect the level of care provided.
- The AOA offers resources to assist with appeals, and practices are encouraged to report ongoing concerns to the AOA at stopplanabuses@aoa.org.
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