Predictors of Insurance Claim Rejection in Hand and Upper Extremity Surgery.

DISCUSSION: Insurance claim rejection occurs frequently (19.3%) in hand/upper extremity surgery and varies by insurance type, with the highest rejection rate occurring in Medicare (31.2%). For a given encounter, the use of multiple Current Procedure Terminology codes and specific modifiers are predictive of rejection risk. LEVEL OF EVIDENCE: Level III, prognostic. PMID: 32427696 [PubMed - as supplied by publisher]

https://www.ncbi.nlm.nih.gov/pubmed/32427696?dopt=Abstract

Source: The Journal of the American Academy of Orthopaedic Surgeons - May 21, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research