decisionhealth Newsletters, Part B News - 2020 Issue 3 (March)
Top E/M code claimants hold steady — but not every code’s a winner
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Article Overview
This article reviews Medicare office evaluation and management claim trends across specialties, comparing 2017 and 2018 volumes, allowed charges, and denial rates. It is aimed at coders, billers, and practice managers who monitor E/M utilization patterns and denial performance by specialty. The discussion stays at a high level while highlighting broad differences in claim behavior among specialties and office visit code groups.
Why This Topic Matters
It helps readers understand how office E/M utilization and denial patterns shifted over time, and why specialty-level benchmarking can matter when reviewing claim performance.
Article Sections
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Benchmark of the week
An overview of Medicare office E/M claim activity and payment trends for the comparison period, along with specialty-level volume observations and denial-rate variation themes.
What You Will Learn
- How office E/M claim volume and allowed charges compared between two recent years
- Which specialties were among the most frequent office E/M claimants
- How denial-rate patterns can vary across specialties and office visit levels
- Why benchmarking specialty-level claim patterns can be useful when reviewing E/M performance
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Revenue cycle staff
- Compliance staff
Codes Discussed
Code Ranges Discussed
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