Palmetto GBA has released its top denial reason codes for January to March 2023 — at the top of the list: “Auto Denial — Requested Records Not Submitted.” That accounted for 38% of claims denied.
At a close second was “Face-to-Face Encounter Requirements Not Met,” with 35.5% of claims denied.
No Plan of Care or Certification was 3rd, with 12.4% of the claims denied.
Other top denial reasons included:
- Information provided doesn’t support the medical necessity of this service.
- No physician’s orders for services