Advanced Search

Ob-Gyn Coding Alert

Reader Question:

Get the Scoop on Medicare's Reasons for Denials

Published on Thu Apr 28, 2005

Question: Do you have a list of Medicare's "Top 10" reasons for denying practices' claims?

Georgia Subscriber Answer: Yes. Here's Medicare's "Top 10":

1. no documentation of service
2. no signature or authentication
3. always assign the same level of service (LOS)
4. consult versus outpatient/office visit
5. invalid codes due to old resources
6. unbundling of procedure codes
7. misinterpreted abbreviations
8. no chief complaint listed/reflected
9. global fee service billed separately
10. inappropriate or no modifier used.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ob-Gyn Coding Alert

View All