Practice Management Alert

Good news: The most common rejections are also some of the easiest to appeal and prevent

Our cover story on denial management suggests that you keep a running list of your office's "Top 10" denials. You may want to compare your list with Medicare's recently released Top 10 reasons for claim rejection to see if there's any overlap.

Remember, you should work systematically to eliminate the cause of each one of these types of denials in your office - or you may simply need to notify the payer why it was wrong in rejecting your claim.

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