Table 3.

Discrepancies in coding level based on the medical record and services heard on audio

Level discrepancy	Note > Audio (Justifies upcode)	Audio > Note (Justifies downcode)	Net difference	Percent of 105 visits	Payment effect (2018)
4 vs 3	19	3	+16	+15%	+$912
4 vs 2	1	0	+1	+1%	+$91
3 vs 2	0	1	−1	−1%	−$34
3 vs 1	1	0	+1	+1%	+$65
All	21	4	+17	+16%	+$1034

Notes: In addition to the 25 visits with discrepancies in coding between the medical record and visit audio recording, 79 visits would be coded at the same level based on both the record and audio (9 as level 2 or lower, 50 as level 3, 20 as level 4) and 1 incomplete encounter, which we treated as nondiscrepant.