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February 20, 2017

2016 Probe Review Error Rates

The J15 Part B Medical Review Department performed Progressive Corrective Action (PCA) reviews on a number of services throughout calendar year 2016. The services reviewed and each calculated error rate are available below.

Strategy Item Average Error Rate
Evaluation & Management 52.1%
Office Visits 44.4%
Critical Care 58.7%
Hospital (Initial and Subsequent) 53.5%
Emergency Room Visits 46.6%
Home Visits 38.7%
Nursing Home and Assisted Living 41.4%
Nursing Facility 78.7%
Ambulance 26.8%
Chiropractic 100%
Drugs 57.3%
Modifier 25 66.1%
Labs 100%

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