decisionhealth Newsletters, Part B News - 2013 Issue 8 (August)
Benchmark: 4 of 5 high-utilization specialties billing 95165 see dips in denials
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Article Overview
This article reviews CMS-derived billing and denial trends for a commonly used allergy immunotherapy preparation service, comparing utilization and denial patterns across the top specialties that report it. It is relevant to practices in allergy/immunology, otolaryngology, family practice, and general practice, as well as coders and revenue cycle staff who monitor claim denial patterns and specialty-level benchmarking.
Why This Topic Matters
The piece helps readers understand how utilization and denial rates vary by specialty over time, which can support benchmarking, payer review, and internal denial management efforts for a frequently billed allergy-related service.
What You Will Learn
- How CMS benchmark data is used to compare specialty-level utilization trends
- Which broad specialties account for the majority of claims for the service discussed
- How denial patterns changed over the compared years for top billers
- Why benchmarking denial rates can be useful for coding and billing review
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- Allergy/immunology practices
- Otolaryngology practices
- Family practice and general practice offices
Codes Discussed
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