TABLE E.1 1998 Medicare Carrier Denial Rates for Top 100 CPT Codes

Obs. No.

CPT

Description

Total Claims

Allowed Services

Denied Claims

Percent Denied

1

G0001

Venipuncture

54,308,311

50,522,357

3,785,954

7

2

80061

Lipid panel

10,012,394

8,112,908

1,899,486

19

3

85025

Automated hemogram

13,484,091

10,641,281

2,842,810

21

4

84443

Assay TSH

5,871,658

4,579,775

1,291,883

22

5

80054

Comp metabolic panel

10,290,202

9,491,333

798,869

8

6

85024

Automated hemogram

8,662,269

7,358,832

1,303,437

15

7

84153

Assay of PSA, total

4,756,531

3,284,409

1,472,122

31

8

80092

Thyroid panel w/TSH

2,534,185

1,974,563

559,622

22

9

85610

Prothombin time

14,291,139

12,574,088

1,717,051

12

10

83036

Glycated hemoglobin test

5,066,357

4,162,652

903,705

18

11

80049

Metabolic panel, basic

5,828,554

5,468,084

360,470

6

12

81000

Urinalysis, nonauto w/scope

10,333,195

9,197,005

1,136,190

11

13

87086

Urine culture/colony count

3,470,828

2,977,871

492,957

14

14

83970

Assay of parathormone

607,387

563,481

43,906

7

15

88342

Immunocytochemistry

773,537

679,395

94,142

12

16

80162

Assay of digoxin

2,217,224

1,719,286

497,938

22

17

82607

Vitamin B-12

1,293,984

1,148,163

145,821

11

18

82728

Assay of ferritin

1,676,425

1,206,352

470,073

28

19

82947

Assay of glucose, quant

6,808,196

5,095,476

1,712,720

25

20

83718

Assay of lipoprotein

2,735,590

1,971,582

764,008

28

21

80058

Hepatic function panel

3,257,316

2,793,817

463,499

14

22

83550

Iron-binding test

2,222,641

1,672,426

550,215

25

23

83540

Assay of iron

3,125,180

2,065,183

1,059,997

34

24

85023

Automated hemogram

1,679,112

1,482,497

196,615

12

25

87186

Antibiotic sensitivity, mic

1,541,216

1,423,826

117,380

8

26

88312

Special stains

750,231

691,029

59,202

8

27

82746

Blood folic acid serum

912,478

791,881

120,597

13

28

80185

Assay of phenytoin, total

839,618

778,174

61,444

7



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