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% |