decisionhealth Newsletters, Part B News - 2016 Issue 3 (March)
Primary care, specialty docs see rising denials on core pulmonary tests
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Article Overview
This article examines denial-rate patterns for frequently billed pulmonary services across primary care and specialty practices, using 2014 claims data as the reference point. It is relevant to physicians, coders, and billing staff who want to understand how denial trends vary by specialty and by commonly reported pulmonary test categories. The piece focuses on comparative claim performance and specialty-level billing patterns rather than detailed coding instructions.
Why This Topic Matters
Understanding where claim denials are rising can help practices identify areas for audit, documentation review, and revenue-cycle monitoring. The article highlights broad utilization and denial patterns for core pulmonary services that matter to primary care, pulmonology, and other specialties.
What You Will Learn
- Which pulmonary service categories are discussed in the denial-rate review.
- How claim denial patterns are compared across specialties.
- Why 2014 claims data are used as the basis for the article’s analysis.
- Which specialties are among the highest-volume billers for the services discussed.
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Revenue cycle teams
- Practice managers
- Pulmonary and primary care practices
Codes Discussed
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