New research shows although the use of diagnostic CT colonography is on the rise, Medicare reimbursement for CTC may vary regionally, according to a study published in the Journal of the American College of Radiology.
For the study, researchers identified Medicare claims for CRC from 2005-2008. Data points extracted from Medicare claims included frequency of billing, denials, physician specialty and location.
Results showed annual claims for CTC increased 195 percent over the studied time period. Half of all claims were denied. However, the annual national denial rate decreased from 70.0 percent to 43.4 percent. Annual regional denial rates ranged from 16.5 percent to 98.3 percent. For example, Atlanta, Seattle and Dallas showed the highest denial rates of 62.4 percent, 65.2 percent and 68.5 percent, respectively.
Of all CTC claims, 92.3 percent were submitted by radiologists, 1.0 percent by gastroenterologists and 1.3 percent by other specialists. Almost all CTC services were performed either in physician offices or outpatient hospital settings, with only a small number in inpatient hospital settings.
Read the study about trends behind diagnostic CT colonography.
Read other coverage about coding and billing:
- AAFP Backs House Bill to Add Contractor Oversight to Medicare Payment Process
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For the study, researchers identified Medicare claims for CRC from 2005-2008. Data points extracted from Medicare claims included frequency of billing, denials, physician specialty and location.
Results showed annual claims for CTC increased 195 percent over the studied time period. Half of all claims were denied. However, the annual national denial rate decreased from 70.0 percent to 43.4 percent. Annual regional denial rates ranged from 16.5 percent to 98.3 percent. For example, Atlanta, Seattle and Dallas showed the highest denial rates of 62.4 percent, 65.2 percent and 68.5 percent, respectively.
Of all CTC claims, 92.3 percent were submitted by radiologists, 1.0 percent by gastroenterologists and 1.3 percent by other specialists. Almost all CTC services were performed either in physician offices or outpatient hospital settings, with only a small number in inpatient hospital settings.
Read the study about trends behind diagnostic CT colonography.
Read other coverage about coding and billing:
- AAFP Backs House Bill to Add Contractor Oversight to Medicare Payment Process
- 5 Tips for Containing Spine Implant Costs
- ACOG Updates Guidelines for Female OB/GYN Screenings