E⁄M Utilization Data
CY 2010 Data (XLS 1.55MB) New 06/07/2012
The most recent E/M utilization data is for dates of services occurring January-December 2010. Data is provided for Iowa Medicaid along with Iowa and national Medicare. The report is sorted in numeric order by the 2-digit code which precedes each specialty, i.e., 01 = general practice; 10 = gastroenterology; 34 = urology, etc.). Please use the accompanying legend, which is in alphabetical order, to locate your specialty.
Remember that the data is useful with some precautions. The data is provided by specialty and show how physicians are using E/M codes. The expected use of any E/M code range is a bell-shaped curve. If the physician(s) in your practice are outside the expected use of E/M codes, there is some risk of audit.
Cautions for this data include: 1) This is billed E/M code data - the documentation has not been evaluated and does not necessarily support the code choice; 2) Do not use this data to justify code choice - only the documentation can validate your code choice.
In data analysis, carriers use the carrier distribution percentages to benchmark physicians, not national distributions. We recommend using the Iowa distribution percentages. Using the national distributions will give physicians a false sense of security since national utilization is always higher than Iowa utilization.
PROVIDER SPECIALTY CODES
79 Addiction Medicine
03 Allergy/Immunology
49 Ambulatory Surgical Center
32 Anesthesiologist Assistant
05 Anesthesiology
78 Cardiac Surgery
06 Cardiology
89 Certified Clinical Nurse Specialist
42 Certified Nurse Midwife
43 Certified Registered Nurse Anesthetist (CRNA)
35 Chiropractic
68 Clinical Psychologist
28 Colorectal Surgery
81 Critical Care (Intensivists)
07 Dermatology
30 Diagnostic Radiology
93 Emergency Medicine
46 Endocrinology
08 Family Practice
10 Gastroenterology
01 General Practice
02 General Surgery
38 Geriatric Medicine
98 Gynecological Oncology
40 Hand Surgery
82 Hematology
83 Hematology/Oncology
17 Hospice and Palliative Care
47 Independent Diagnostic Testing Facility (IDTF)
95 Independent Physiological Laboratory
64 Independently-billing Audiologist
69 Independently-billing clinical laboratory
62 Independently-Billing Psychologist
67 Independently-practicing occupational therapist
65 Independently-practicing physical therapist
44 Infectious Disease
11 Internal Medicine
09 Interventional Pain Management
94 Interventional Radiology
80 Licensed Clinical Social Worker
45 Mammography Screening Center
73 Mass Immunization Roster Biller
85 Maxillofacial Surgery
90 Medical Oncology
58 Medical Supply Company w/ Registered Pharmacist
39 Nephrology
13 Neurology
14 Neurosurgery
86 Neuropsychiatry
36 Nuclear Medicine
50 Nurse Practitioner
16 Obstetrics/Gynecology
18 Ophthalmology
96 Optician
41 Optometry
19 Oral Surgery (dentists only)
20 Orthopedic Surgery
12 Osteopathic Manipulative Therapy
87 Other Suppliers
04 Otolaryngology (ENT)
72 Pain Management
22 Pathology
37 Pediatric Medicine
76 Peripheral Vascular Disease
25 Physical Medicine and Rehabilitation
97 Physician Assistant
24 Plastic and Reconstructive Surgery
48 Podiatry
63 Portable X-Ray Supplier (billing independently)
84 Preventive Medicine
26 Psychiatry
60 Public Health or Welfare Agencies
29 Pulmonary Disease
92 Radiation Oncology
74 Radiation Therapy Centers
71 Registered Dietician/Nutrition Professional
66 Rheumatology
70 Single or Multispecialty Clinic or Group Practice
91 Surgical Oncology
33 Thoracic Surgery
21 Unassigned
23 Unassigned
27 Unassigned
31 Unassigned
99 Unknown Physician Specialty
88 Unknown Supplier/Provider
34 Urology
77 Vascular Surgery