decisionhealth Newsletters, Part B News - 2012 Issue 12 (December)
Benchmark of the Week: Top 10 high-growth, high-denial codes, 2010-2011
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Article Overview
This article examines CMS claims data to identify procedure codes that experienced both notable utilization growth and comparatively high denial activity from 2010 to 2011. It is aimed at coding and revenue-cycle professionals who want to understand broader denial and utilization trends across selected procedure categories and how those trends may affect practice performance.
Why This Topic Matters
The article helps readers spot general patterns in denial and utilization growth that may affect operational oversight, payment integrity review, and denial management priorities.
What You Will Learn
- How CMS claims data was used to compare utilization trends across two years
- Which broad procedure categories were included or excluded from the analysis
- How denial-rate trends were evaluated alongside utilization growth
- What the article suggests about monitoring high-growth services for denial activity
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle professionals
- Practice managers
- Payer compliance staff
Codes Discussed
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