decisionhealth Newsletters, Part B News - 2016 Issue 10 (October)
Denial rates nudge lower on oft-reported E/M claims, rise on low levels
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Article Overview
This article reviews Medicare claims data for office-based evaluation and management services and compares denial patterns across frequently reported and lower-level office visit codes over a three-year span. It is relevant to coders, billing staff, and practice administrators who monitor claim rejection trends and denial performance in E/M reporting.
Why This Topic Matters
Understanding denial trends by office visit level can help revenue cycle teams assess where claims are most vulnerable and where overall denial performance is strongest. The article provides context for Medicare E/M claim patterns without replacing detailed coding guidance.
What You Will Learn
- How denial rates varied across office visit evaluation and management claims over time
- Which broad E/M office visit levels were most commonly reported in the Medicare data set
- How overall denial patterns compared with lower-level office visit claims
- What the article’s Medicare claims analysis suggests about claim volume and denial frequency
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Practice managers
- Healthcare administrators
Codes Discussed
Code Ranges Discussed
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