DecisionHealth, DecisionHealth - 2010 Issue 9 (September)

Benchmark of the Week: E/M denial rate differences by specialty, 2008

Summary: Do certain specialties do a lot worse on getting paid for high-level E/M codes? This analysis takes a shot at the question by looking at the difference in the denial rate for level 3 E/M codes and level 5 E/M codes. Remember: Level 3 E/Ms are the single most commonly billed Medicare service, according to years of CMS claims data (PBN 10/12/09). NOTE: These specialties were chosen for having high annual Medicare utilization, and to ensure a diverse range of practices would be represented.

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