decisionhealth Newsletters, Part B News - 2011 Issue 2 (February)
Benchmark of the Week: What has the greatest impact on E/M denials?
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Article Overview
This article reviews denial trends for evaluation and management (E/M) services using CMS claims data and compares how denials vary by patient type, place of service, and service level. It is intended for coding, billing, and revenue cycle professionals who want a high-level view of denial patterns and the general factors examined in the benchmark charts.
Why This Topic Matters
Understanding broad denial trends can help billing teams and coders evaluate where denial risk is most likely to appear in E/M reporting and compare patterns across common care settings.
Article Sections
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Benchmark overview
Introduces the benchmark charts and the broad factors being compared across office and inpatient E/M services.
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Breakdown
Summarizes the comparative denial pattern analysis and the way the service categories are organized for the chart review.
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Takeaways
Provides the article’s overall high-level observations about the relative impact of the factors reviewed.
What You Will Learn
- How the article frames denial analysis for E/M services
- Which broad categories are compared in the benchmark charts
- How the article presents the data source and time frame
- What types of readers may find the benchmark useful
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Practice managers
- Compliance teams
Codes Discussed
Code Ranges Discussed
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