decisionhealth Newsletters, Part B News - 2016 Issue 5 (May)
Denials trend down on post-operative E/M, ophthalmologic codes
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Article Overview
This article reviews denial trends tied to post-operative evaluation and management services and ophthalmologic office/eye exam reporting, using Medicare claims data to compare two consecutive years. It is relevant to coders, billers, practice managers, and specialty providers who monitor claim performance and denial patterns. The discussion centers on broad denial-rate changes, frequently billed service categories, and specialty-specific trends from a Part B News analysis.
Why This Topic Matters
Understanding denial trends helps practices identify where claims performance is improving or weakening across commonly billed services. For organizations that track reimbursement and denial management, the article provides context on how post-operative E/M and eye exam reporting behaved in Medicare claims data.
What You Will Learn
- How denial trends changed over a two-year period for commonly billed post-operative services
- Which categories of outpatient evaluation and management services were most frequently associated with denials
- How ophthalmology-related claims compared within the broader denial trend discussion
- What Medicare claims data can reveal about denial performance by service type and specialty
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Ophthalmology practices
- Other specialty providers using Medicare claims data
Codes Discussed
Modifiers Discussed
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