DecisionHealth, DecisionHealth - 2011 Issue 3 (March)

4 tips to reduce established E/M denials as carriers begin using tougher standards

You must take your documentation to the next level to avoid being snared by carriers who use tougher medical necessity standards on one of the most common service types: established E/M visits. Extremely high error rates – averaging 51% and 91% – were found for codes 99211-99215 by one carrier during its most recent medical review.
 

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