decisionhealth Newsletters, Part B News - 2019 Issue 1 (January)
TCM utilization growth is impressive; denial rate drop even more so
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Article Overview
This article examines Medicare-era trends in transitional care management billing, focusing on how usage and denial patterns have evolved across specialties over time. It also places those trends in the context of related discharge management services and broader provider utilization patterns, making it relevant for coders, billing staff, compliance teams, and practice leaders tracking outpatient hospital follow-up coding activity.
Why This Topic Matters
Understanding changes in utilization and denial trends helps practices benchmark performance, monitor revenue cycle issues, and identify where coding activity is shifting across specialties and mid-level providers.
Article Sections
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Benchmark of the week
Overview of national utilization and denial trend observations tied to transitional care management coding across multiple specialties.
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Related discharge management utilization trends
Discussion of how related discharge management activity has changed over time and how it relates to provider mix and broader billing patterns.
What You Will Learn
- How transitional care management billing patterns have changed over time
- How denial trends can be used as a performance benchmark
- How related discharge management services fit into the broader utilization picture
- Which provider types are highlighted in the discussion of billing patterns
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Practice administrators
- Revenue cycle analysts
Codes Discussed
Code Ranges Discussed
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