decisionhealth Newsletters, Part B News - 2013 Issue 9 (September)
Benchmark of the Week: Biggest increases, decreases in ASP drug utilization rate, 2011-2012
Subscribe or sign in to view the full article.
Article Overview
This article discusses Medicare drug utilization trends between 2011 and 2012 and highlights why some billed drug services experienced noticeable changes in use. It is aimed at coders, billers, and reimbursement professionals who monitor ASP drug utilization and claim denial patterns. The piece also touches on general caution areas involving Medicare coverage and billing code selection.
Why This Topic Matters
Understanding shifts in drug utilization and denial patterns helps billing teams identify items that may warrant closer review, especially when claims behavior changes over time or when coverage assumptions differ by benefit category.
What You Will Learn
- How Medicare drug utilization patterns changed between 2011 and 2012
- Why utilization growth does not necessarily align with denial patterns
- What kinds of billing situations may merit closer coverage review
- How the article frames cautionary examples related to Medicare drug billing
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Reimbursement analysts
- Practice managers
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com