decisionhealth Newsletters, Part B News - 2022 Issue 11 (November)
Denials for prolonged codes hint at trouble for practices in the new year
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Article Overview
This article explains recent denial trends for prolonged services under Medicare Part B and reviews the upcoming coding changes that affect office/outpatient reporting and standalone prolonged service claims. It is aimed at practices, physicians, and qualified health care professionals that need to understand the scope of the update and the areas most likely to be affected.
Why This Topic Matters
The topic matters because denial patterns and code-set changes can affect claim acceptance, workflow, and billing preparation for the new year. Readers will want to know which reporting areas are involved and how the policy shift may affect existing prolonged service claims.
What You Will Learn
- How Medicare Part B denial trends for prolonged services changed over time
- Which broad outpatient and prolonged service reporting areas are affected by the coding update
- Why upcoming code-set changes may increase claim risk for affected practices
- What kinds of Medicare claim data and policy changes are discussed in relation to denials
Who Should Read This
- Physicians
- Qualified health care professionals
- Medical coders
- Billing staff
- Revenue cycle managers
- Practice administrators
Codes Discussed
Code Ranges Discussed
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