Table 4.
Proportion of Central DXA Claims Denied Reimbursement, by State Medicare Carrier and Testing Interval
| Medicare Carrier and Associated States Covered* | Initial DXA | Repeat DXAM |
|
|---|---|---|---|
| < 23 months | >= 23 months | ||
| Proportion Denied (%) |
Proportion Denied (%) |
Proportion Denied (%) |
|
| Wisconsin Physician Services (WI, IL, MI) | 5.8 | 42.5 | 3.4 |
| Cahaba GBA (AL, GA, MS) | 6.3 | 41.6 | 3.0 |
| Physician Services (MN) | 6.1 | 38.3 | 4.2 |
| First Coast Service (FL, CT) | 6.5 | 32.0 | 3.2 |
| Cigna (NC, TN, ID) | 7.1 | 29.7 | 3.1 |
| BC/BS of RI (RI) | 4.4 | 28.6 | 2.0 |
| Palmetto (OH, WV, SC) | 6.3 | 27.7 | 3.9 |
| NHIC (CA, ME, NH, MA, VT) | 5.2 | 19.1 | 2.9 |
| Trailblazer (TX, VA, MD, DE, DC) | 7.0 | 18.6 | 5.2 |
| New York*** | 4.7 | 14.6 | 4.0 |
| Adminastar (IN, KY) | 6.3 | 6.7 | 2.3 |
| BC/BS of Ark. (NM, OK, AR, LA, MO) | 4.1 | 5.3 | 3.3 |
| BC/BS of Utah (UT) | 6.0 | 4.3 | 0.0 |
| Empire (NJ) | 4.7 | 4.0 | 3.3 |
| Noridian (CO, WY, IA, ND, HI, NV, SD, OR, WA, AZ, AK, MT) | 4.3 | 3.8 | 2.3 |
| HGSA Admin (PA) | 4.5 | 3.7 | 2.8 |
| BC/BS of Kansas (KS, NE) | 4.2 | 1.9 | 4.2 |
| Total Proportion Not Paid* | 5.7 | 18.6 | 3.4 |
| P value for column | < 0.0001 | < 0.0001 | < 0.0001 |
Data are sorted by the proportion of DXAs repeated at < 23 months that were denied
*
Total number of DXAs performed is the same as shown in Table 3
**
New York has multiple carriers