An employee of Family Health Centers of San Diego who was certified as a medical coder has made a disturbing allegation we have heard before - that FHCSD encourages "upcoding" for routine visits.   Specifically, this employee, who left the organization late last year, says the pressure to upcode is most intense at the E/M (evaluation and management) level which prevents anyone from seeing the "larger picture".   If true, this should be investigated immediately -- manipulation of data like this is toxic and corrupting for any organization, and it is possible it has been going on for a long time at FHCSD.    This employee also described incompetent management and obvious favoritism.