decisionhealth Newsletters, Part B News - 2018 Issue 1 (January)
E/M use for top M.D.s dropped in 2016 — but NPPs’ use rose
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Article Overview
This piece examines Medicare office evaluation and management service trends over a multi-year period, including overall utilization, specialty-level shifts, and denial rates. It is relevant for coders, billing teams, auditors, and practice leaders who monitor office E/M volume patterns and payer experience across physician and non-physician practitioner groups. The article also highlights which office E/M codes were most frequently billed in the reported year and places those findings in the context of broader utilization changes.
Why This Topic Matters
Understanding changes in office E/M utilization and denial rates can help coding and billing professionals benchmark performance, identify shifting provider mix, and interpret Medicare claims trends affecting office visit reporting.
Article Sections
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Benchmark of the week
An overview of Medicare office E/M utilization trends across recent years, including specialty-level patterns and denial-rate movement.
What You Will Learn
- How office E/M utilization changed across the reported Medicare years
- Which provider groups showed increases or decreases in office E/M use
- How denial rates for office E/M services varied over time
- Which office E/M services were among the most frequently billed in the reported year
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Compliance auditors
- Practice managers
- Healthcare analysts
Codes Discussed
Code Ranges Discussed
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