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DecisionHealth, DecisionHealth - 2010 Issue 1 (January)

Benchmark of the Week: Surgery code denial rates, 2007-2008

Summary: Denials for 10 of the most common surgery codes billed to Medicare have fallen almost across the board from 2007 to 2008, reversing a trend of slight increases in denial rates from 2006 to 2007. NOTE: The codes were selected based on utilization figures and associated specialty, including ambulatory surgery centers (ASCs), to ensure that a variety of surgical procedures were represented. The bold numbers above the bar graphs indicate the change in denial percentages over the one-year period. NOTE: The dollar amounts for each code below are based on the 2010 Medicare Physician Fee Schedule.

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