How to Stop Medicare Claim Denials Due to Medical Necessity

Posted by Advent Health Partners on May 5, 2017 11:25:32 AM

With the shift towards value-based care coupled with the ICD-10 coding requirements, Medicare claim denials for medical necessity will most likely continue to plague your healthcare revenue cycle. Because medical necessity denials usually stem from inadequate documentation on the claims, the first line of attack to conquer the problem must come from physician documentation. ICD-10 calls for greater specificity than ever before. What may have passed under ICD-9 as proper coding for medical necessity may be insufficient today.

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