Noridian Medicare just released last week the top five denials for October through December.
The top five are:
Non covered because the service is not deemed medically necessary
The procedure code or modifier was invalid for that service date
Claim denied as patient can not be identified
Claim lacks the NPI of the referring or ordering physician
or NPI is invalid
Maximum benefits for time period have been exceeded
The Part B newsletter can be found at the link below:
https://www.noridianmedicare.com/provider/updates/docs/top_claim_submission_errors_Oct-Dec.pdf
What is more shocking, is that all of these reasons are easily preventable. By simply checking benefits and eligibility four of them can be eliminated and there are NPI look ups through NPPES.
We'll go more in depth on how to solve these denials in future posts or for tips on how to eliminate these denials in your office, give us a call, we'd love to help!
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