New research shows the findings of how many times Chronic Care Management codes are used within different service environments. CCM codes have been on the rise recently, but denial rates have gone up as well. Read below to find out more.
Chronic Care Management (CCM) code usage has been on the rise recently. CCM codes 99490 [primary CCM], 99487 and 99489 [complex CCM] rose 23%, 78% and 285% respectively between 2017 and 2018. In 2018 CCM code 99490 was reported 4.3 million times with almost 90% of these reported in the Office setting or 3.8 million claims. That may seem like a lot but when we look at the denial rates, Office (POS 11) had only a 4% denial rate. Of the remaining 500,000 claims outside of POS 11, 225,569 claims were submitted with POS 12 (Patient’s Home) with a 7% denial rate.
After the top two reported Place of Service (POS) codes the number of claims per POS drop significantly, however, the denial rate for some POS codes increase significantly. POS 21 (Inpatient Hospital) claims had a denial rate of 19%. Part B News Volume 34, Issue 24 from June 22nd has a great visual of this information in an article by Roy Edroso.
Click here to read the article from Part B News!