decisionhealth Newsletters, Part B News - 2015 Issue 6 (June)
Top 12 most reported and denied codes include therapy, allergy, E/M services
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Article Overview
This article reviews a Medicare claims analysis of widely billed services that also experienced relatively high denial rates. It is aimed at coding and reimbursement professionals who want a high-level view of denial patterns across service categories such as therapy, allergy testing, laboratory/pathology, chiropractic care, and evaluation and management. The piece frames the topic in terms of reported utilization, denial frequency, and the financial impact of denials without providing detailed coding guidance.
Why This Topic Matters
Understanding which heavily used services also face denials can help revenue cycle and coding teams identify areas that may warrant closer review. The article provides a broad signal about where payer scrutiny may be affecting reimbursement and denial volume.
What You Will Learn
- Which broad service categories appear among the most frequently billed codes with notable denial rates.
- How Medicare claims data can be used to understand utilization and denial patterns.
- Why denial volume can have significant financial impact for commonly reported services.
- The general types of services represented in the article’s analysis.
Who Should Read This
- Medical coders
- Revenue cycle professionals
- Billing specialists
- Compliance teams
- Practice managers
- Healthcare administrators
Codes Discussed
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