What is the most common reason for denial of claims for diagnostic audiology testing?
• Our analysis shows the most common denial reason is provider submission of insufficient documentation to support medical necessity. As a reminder, services are excluded under Section 1862(a)(7) of the Social Security Act when: • The diagnostic information required to determine the appropriate medical or surgical treatment is already known to the physician, or • The diagnostic services are performed only to determine the need for, or the appropriate type, of a hearing aid.
