looking for data to compare your practice against, the Medical
Group Management Association (MGMA) may have the answer.
MGMA issued its 2004 Coding Profile Sourcebooks for primary
care, medical and surgical specialties, pathology and radiology.
The books include the most-often performed procedures and
diagnoses, broken down by age and gender, for 36 specialties.
MGMA data covers 74 million procedures during calendar year
2003, and breaks down key CPT codes by diagnosis. The data
covers younger patients as well as Medicare beneficiaries,
so you can track the reasons for patient visits based on
can use the MGMA data to benchmark your practice's utilization
of certain codes against the national average, or see whether
you're claiming a particular diagnosis more often than comparable
practices. The MGMA gives the example of an ophthalmology
practice that discovers it's billing for refractions less
often than most other practices, thereby losing out on reimbursement.