DecisionHealth, DecisionHealth - 2011 Issue 11 (November)

Benchmark of the Week: Major procedure denial rates, 2009 vs. 2010

This chart looks at denial rates and utilization changes for 10 major surgical procedures that are some of the highest-value services paid by Medicare, based on the latest CMS claims data. NOTE: While a denial rate of 10% or more is typically considered high, each of these codes are worth thousands of dollars, so a rate of 5% or more is considered high, given the amount of revenue at stake.

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