Outpatient Facility Coding Alert - 2008 Issue 14
CODE UTILIZATION: Compare Your Top 10 Billed Codes to Medicare's
Subscribe or sign in to view the full article.
Article Overview
This article summarizes Medicare’s published Part B utilization data for 2006 and explains how the statistics can help practices compare their own billing patterns with national Medicare-paid usage. It is aimed at coders, billing staff, compliance teams, and clinicians who want to understand broad utilization trends across evaluation and management, consultations, laboratory testing, procedures, and specialty-specific billing patterns.
Why This Topic Matters
Medicare utilization data can provide a benchmark for understanding how frequently certain services are billed overall and within specialties. For practices, this kind of article is useful for identifying coding mix trends and for reviewing whether billing activity aligns with broader utilization patterns.
Article Sections
-
Medicare utilization data overview
Introduces the latest claims processing and utilization statistics released by CMS for Medicare Part B services. The section frames the article as a comparison of practice billing patterns against national data.
-
Top reimbursed codes overall
Summarizes the most frequently paid services in the Medicare dataset, including general office, laboratory, inpatient, and procedure categories. The discussion highlights broad utilization trends rather than detailed coding guidance.
-
Evaluation and management utilization by specialty
Reviews how E/M service frequencies vary by specialty and notes differences between common visit levels and specialties that bill them often. The section focuses on comparative utilization patterns across provider groups.
-
Consultation code utilization by specialty
Describes Medicare’s consultation coding statistics and identifies specialties with the highest billing volume for certain consult services. The section presents utilization comparisons for consultation claims across physician specialties.
What You Will Learn
- How Medicare Part B utilization statistics can be used as a billing benchmark
- Which broad service categories appear most frequently in the national Medicare data
- How evaluation and management billing patterns can differ by specialty
- How consultation utilization varies among specialties
- Why published utilization files may be useful for reviewing coding mix and claim patterns
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance teams
- Physicians
- Revenue cycle professionals
Codes Discussed
Subscribe or sign in to view the full article.


Quick, Current, Complete - www.findacode.com