DecisionHealth, DecisionHealth - 2009 Issue 10 (October)

NPP Report: Minor procedures behind NPPs' low-level E/M denials

Non-physician practitioners (NPPs) are seeing a high denial rate on low-level E/M codes, according to an NPP Report analysis of the latest CMS claims data. 99212 (office/outpatient visit, est., $37.15) was denied an astounding 20.2% of the time in 2008 - that's more than one denial for every five claims submitted. 99211 (office/outpatient visit, est., $18.75) had a 40.6% denial rate in 2008.

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