decisionhealth Newsletters, Part B News - 2013 Issue 1 (January)
Benchmark of the Week: Top denied preventive services, 2011 vs. 2010
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Article Overview
This article reviews CMS claims data on the most-utilized preventive services with the highest denial rates in 2010 and 2011. It is aimed at readers who monitor Medicare preventive service billing and denial trends, and it highlights broad patterns in denial frequency, service mix, and the appearance of annual wellness visit billing in the dataset.
Why This Topic Matters
It helps practices and revenue cycle teams understand where preventive service denials were most common and compare their own denial performance against national benchmark data.
What You Will Learn
- How denial rates for preventive services compared between 2010 and 2011
- Which broad categories of preventive services were most frequently denied
- How CMS claims data were used to frame the benchmark
- Why preventive service denials can affect reimbursement and documentation review
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Billing specialists
- Practice managers
- Compliance staff
Codes Discussed
Code Ranges Discussed
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