DecisionHealth, DecisionHealth - 2011 Issue 4 (April)

Benchmark of the Week: Top imaging denials by place of service, 2009

This chart looks at how denial rates for top-dollar, high-utilization imaging services are impacted by the place of service (POS). NOTE: A total of four POS codes were used, office (11), outpatient hospital (22), inpatient hospital (21) and emergency room (23). These were combined into inpatient/emergency room and outpatient/office to make the data more accessible at a glance. NOTE: The imaging codes were chosen based on a combination of their annual Medicare utilization and total value in Medicare dollars paid, based on CMS claims data from 2009.

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