decisionhealth Newsletters, Part B News - 2016 Issue 6 (June)
Denial rates of common allergy codes change — but remain tough to get paid
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Article Overview
This article examines Medicare claims data for allergy skin testing and related billing trends over several years, with emphasis on denial-rate patterns, utilization differences, and the impact of a 2013 code change. It is relevant for clinicians, allergy/immunology practices, coders, and billing staff who follow CPT reporting and payer adjudication trends for allergy testing services. The discussion focuses on general denial-rate analysis, code-usage patterns, and the way Medicare data reflect shifts in billing behavior.
Why This Topic Matters
Allergy testing services are common in specialty practice, and denial trends can affect reimbursement, workflow, and coding review. Understanding which allergy testing services are drawing more denials helps practices monitor billing performance and payer response over time.
Article Sections
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Benchmark of the week
Introduces the Medicare-based denial-rate analysis for allergy skin testing services and frames the overall trend being discussed.
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Denial trends and code changes
Reviews multi-year denial patterns across allergy testing services, including the effect of a 2013 code revision and differences in utilization across services.
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Source
Identifies the underlying Medicare claims analysis used for the article's discussion.
What You Will Learn
- How Medicare denial patterns for allergy testing services are being tracked over time
- How a code revision in allergy testing is reflected in billing trend discussions
- Why utilization volume matters when interpreting denial-rate data
- What general types of allergy testing services are included in the analysis
Who Should Read This
- Medical coders
- Billing staff
- Allergy/immunology practices
- Revenue cycle professionals
- Healthcare administrators
Codes Discussed
Code Ranges Discussed
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