10 Top Ambulatory Care Procedures & Unexpected Denial Rates

Laura Dyrda -

Here are the top 10 procedures performed at ambulatory care facilities by total billed amounts from Nov. 15, 2012 to Feb. 11, 2013, and the denial rates for each procedure based on data collected by RemitDATA, an independent source of comparative analytics for reimbursement, utilization and productivity data. The database houses 25 percent of all national outpatient remits.

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1. Proton treatment simple with comp.: 10 percent
2. Proton treatment intermediate: 10 percent
3. Cataract Surgery With IOL 1 Stage: 7 percent
4. Upper GI/Endoscopy Biopsy: 8 percent
5. Provide INR Test Mater/Equipment: 10 percent
6. Stereoscopic X-Ray Guidance: 6 percent
7. Office/Outpatient Visit, Est. (CPT 99214): 9 percent
8. Office/Outpatient Visit, Est. (CT 99213): 7 percent
9. Radiation Tx Delivery Intensity Modulated Radiation Therapy: 14 Percent
10. Colonoscopy and Biopsy: 9 percent

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