DecisionHealth, DecisionHealth - 2011 Issue 12 (December)

Benchmark of the Week: Most damaging NPP denials, 2009 vs. 2010

These charts show 10 codes billed by non-physician practitioners (NPPs) that have relatively low denial rates, but were responsible for a major chunk of lost reimbursement in 2010. The top chart shows the average dollar amount lost per single denial in 2009 and 2010, while the bottom chart shows the average denial rate. NOTE: For the purpose of this analysis, NPPs include certified nurse midwives, certified registered nurse anesthetists (CRNAs), chiropractors, clinical nurse specialists, nurse practitioners, physician assistants and physical therapists. CMS does not distinguish between physician-billed services and those billed incident-to by NPPs, so this data excludes incident-to services.

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