decisionhealth Newsletters, Part B News - 2011 Issue 10 (October)
Benchmark of the Week: E/M denials by specialty, 2009-2010
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Article Overview
This article reviews denial rate trends for evaluation and management services across 10 specialties with high Medicare utilization, using 2010 CMS claims data and comparing outpatient and inpatient patterns. It is intended for coding, revenue cycle, and practice management audiences who want to understand denial trends by specialty and service level and how the benchmark data is presented.
Why This Topic Matters
It helps readers gauge whether their specialty’s denial experience is in line with broader benchmark patterns and highlights where denial trends may have financial impact across commonly billed E/M services.
Article Sections
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Summary
An overview of the chart-based benchmark focus, including the specialties and time period analyzed.
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Breakdown
A comparative discussion of denial-rate patterns across specialties and service levels, with emphasis on relative trends shown in the charts.
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Takeaways
A summary of the broader implications of the benchmark data for denial trends and utilization across high-volume specialties.
What You Will Learn
- How the article compares denial rates across multiple specialties
- What broad outpatient and inpatient E/M service categories are included in the benchmark
- Which general specialty groups are discussed in the denial-rate charts
- How the article frames denial trend changes using CMS claims data
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Practice managers
- Billing professionals
- Healthcare consultants
Codes Discussed
Code Ranges Discussed
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