For retrospective reviews, we compare utilization patterns against CMS national stats for the same specialty, and pull claims where they are identified as outliers, since those pose the greatest risk, and have the highest potential for error. We use software called Anodyne Analytics to find the most frequently billed codes for each provider.
You'll either need software that has the same types of reporting functions as Anodyne, or the ability to run custom reports with your current billing software...You can also buy audit software that comes with national stats pre-loaded - but if you'd rather not spend the extra money, you can find the info here:
You've got to calculate the percentages yourself, though, and there's not anything newer than 2008 available, but it's better than nothing! Hope that helps!
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